CHESAPEAKE-POTOMAC SPINA BIFIDA ASSOCIATION, INC.

“DIRECTORY OF SERVICES FOR INDIVIDUALS WITH
SPINA BIFIDA AND RELATED CONDITIONS”
2006 EDITION

ORDER FORM

ORGANIZATION: ______________________________________________

ADDRESS:

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CONTACT: ______________________________________________

PHONE:

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PLEASE SEND _____ COPIES @$9.00 EACH = $________.
MAKE CHECK PAYABLE TO:

CPSBA
P.O. Box 1750
Annapolis, MD 21404

For further information, contact CPSBA at 1-888-733-0988.

Please allow 3 weeks for printing and mailing of directory.

THANK YOU