Ohio Telephone Reader Consumer Application

There are just a few questions on this application. Please answer them all so that your application can be quickly processed. Please select:   Mr.   Mrs.    Ms. First Name: Last Name: Home address: City: County: State: Zip Code: Daytime telephone number: Your email address: Your age:   Please check items that apply:  I am a Reading Service Consumer  I am a talking book subscriber  I use screen access software  I use BSVI services   That completes your application. We will respond to you within ten days. Click the submit button below to send your application.