Author: DiBonaventura, Lisa (DDS)
Last saved by: kenneyk3@gmail.com
Company: EOHHS

APH Products Catalog 2021 – 2022
CW, Metro, NE & SE Region APH Order Form

APH Products Catalog 2023 – 2024
CW, Metro, NE & SE Region APH Order Form

Individual:  					       	Date:   
DDS Region:						Phone:  
Requested By:        					Email:
Please indicate Home or Day Services:						 

Please use this form to place APH orders and use additional pages if needed.
Available APH products can be found Online at: https://www.aph.org/shop/ OR in the 2023-2024 APH Instructional Products Catalog (paper catalog with a Black cover).  If you’d like a paper catalog, please call APH at 1-800-223-1839.  Please do not use outdated APH catalogs as Products, Prices, and Item #'s may have changed! 
      Any item that notes “Not available with QUOTA funds” cannot be ordered.

Page | Item Description | Item Number | Quantity | Item Price | Total Price
| | | | Total:

Shipping Information:					   Phone:  
Attention to:
Program Name:
Mailing Address and Zip Code:

Please mail, fax or email completed form to Sandra:
Sandra Faulkner 					Sandra.M.Faulkner@mass.gov
Vision and Vision Loss Services		Office: 508.384.5679 
WDC / P.O. Box 144				Fax:	  508.384.6771
Wrentham, MA 02093

Any questions please call Lisa DiBonaventura @ 508.384.5539
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APH Federal Quota Account October 1, 2023 - September 30, 2024 	Page 1