Deaf Cultural Programming, Networking and Library Friends
TWO FORMS:
I. Order Form - 2012 LDA Special Packet
II. Application Form - OSD –US Directory
(ODS stands for Organizations Serving the Deaf Community)
I. Order Form:
2012 LDA Special Packet which includes the following:
· One Abbé de l’Épée poster, by Jean Boutcher, deaf artist,
In colors and laminated (11” x 17”)
· One booklet, “Abbé de l’Épée in America” by Alice L. Hagemeyer (8.5” x 11” over 20 pages)
· Three posters (8.5” x 11”)
Deaf American Reads (by Lois Hoover, artist)
Clerc-Gallaudet Week: Dec 3-9
National Deaf History Month: March 13 – April 15
To order: please include the recipient’s name, mailing address, and where applicable, title, and name of the company.
For a single packet, please enclose a check for $30.00 and payable to Library for Deaf Action. Discounts are available for orders of 10 or more packets.
II. Application Form for listing in the Directory and registering to FOLDA E:News
1. Categories Check only one of the following four:
__ Academic (colleges, universities, others)
__ Public (government services, libraries, others)
__ School (elementary, middle and high school)
__ Special Check only one of the following five:
__Auxiliary (communication access, technologies)
__Consumer (membership, advocacy)
__Services (human, social)
__Faith-related (religious, spiritual)
__Media (publishers, producers, distributors, News services)
2. Status Check only one of the following:
___ International based in the US
___ National
___ State / Regional States
___ County / Regional Counties
___ City / Regional towns
3. Zip code, town of the physical address or of the contact
4. Organizational name and acronym
5. Founding year (if not known, use the year it was incorporated or when the first director or president was appointed)
6. Additional organizational name (i.e. department, division, branch, unit or related; Acronym and founding year:
8. Web site address
*9. Contact:
Name ______
Title______
Email address ______
*Note: Contact name receives free subscription to FOLDA E: NEWS
Mail both forms to
Library for Deaf Action
2930 Craiglawn Road
Silver Spring, MD 20904-1816
Thank you! Ldaforms08-15-12