The Metro Washington Association
of the Deaf-Blind

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MWADB MEMBERSHIP FORM

The Metropolitan Washington Association of the Deaf-Blind (MWADB) is a social organization which meets monthly. Each member is entitled to receive quarterly newsletters, the latest e-news, and discount rates for social gatherings.

 rNEW   rRENEWAL   rCHANGE OF ADDRESS

Name(s):_____________________________________________
Address:_____________________________________________
City, State, Zip+4:______________________________________
E-mail address:_____________________ Fax #:(___)___-_____

Want on e-mail news list for announcements? Yes ___ No ___

Home Phone #: (___)___-____ Work Phone #: (___)___-_____

Your Birthday for newsletter greeting (month/day):__________

Make a check or money order payable to the order of
MWADB and mail this form along with the payment to:
Mae Lynn Mullen
Blaire East
1220 East West Hwy # 119
Silver Spring, MD 20910