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CLEARINGHOUSE ON AGING AND DEVELOPMENTAL DISABILITIES
REHABILITATION RESEARCH AND TRAINING CENTER ON
AGING WITH DEVELOPMENTAL DISABILITIES



Name:______________________________________Address: ____________________________

Organization:________________________________City/State/Zip__________________________

Phone Number: (      ) _____  - ___________ e-mail: ________________________________

Would you like us to add your name to the A/DDvantage newsletter mailing list?  .............   [        ]
Would you like us to add your name to the eA/DDvantage (electronic) newsletter mailing list?  .............   (Email address)
 

RRTCADD PRODUCT ORDER FORM
Item No. Quantity Item Title Item Cost
1. . . . .
2. . . . .
3. . . . .
4. . . . .
5. . . . .
6. . . . .
TOTAL XXXXXXXXX XXXXX XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX $________

REMEMBER, ALL JOURNAL ARTICLES ARE $3.25 EACH.

Make check or purchase order payable to:     Department of Disability & Human Development    (Fed. ID #37-6000511)

Mail payment to:

RRTC Clearinghouse on Aging and Developmental Disabilities,
Institute on Disability & Human Development M/C 626
1640 W. Roosevelt Road, Chicago, IL 60608-6904.

For further information call Erika Magallanes:

(312) 413-1520 (V) or (312) 413-0453 (TTY) / Fax: 312-996-6942

Outside Chicago call:

(800) 996-8845; (800) 526-0844 (Illinois Relay Access)
 

Funded by the United States Department of Education, Office of Special Education and Rehabilitation Services,
National Institute on Disability and Rehabilitation Research Cooperative Agreement #H133B031134