Application and Registration for Service


If you encounter difficulties with the application or have any questions, please call Sun Sounds of Arizona
at 480-774-8300 for more information.

1. ELIGIBILITY - You are eligible for services from Sun Sounds of Arizona at no charge if you cannot read
printed materials due to a disability.

2. VERIFICATION REQUIREMENTS - Please provide the name, title and phone number of a verifying
authority such as a Doctor, Registered Nurse or Professional Staff of a Medical Facility or a Public
or Private Agency or a Sun Sounds Representative. Their signature is not required but we may contact them
to verify your eligibility.

3. NOTIFICATION - It is important to notify Sun Sounds if and when you change your address
and/or your phone number. Updated Program Schedules will be mailed to the address we have on record.


General Information - We do not sell or share any of your information.

First and Last Name
Address
City
State/Prov
Zip/Postal
Phone Number
Email Address
What is your date of birth?

Please complete the following information on race and ethnicity which will provide Sun Sounds of Arizona eligibility for federal funds.

Race




Please, specify:
Ethnicity

What is your disability?


Name of Verifying Authority
Verifying Authority Phone Number
If you live in a facility. Facility Name and Number
Service Requested

If not listening via radio, I will listen via ...


Program Schedule

Choose your preferred format (Please choose no more then 2 formats).



How did you hear about Sun Sounds?

Please use the following field to tell us how you learned about Sun Sounds.

This Section Applies To Sun Sounds Radio Service Only. This is a Statement of Agreement and Responsibility.

Please understand that the Sun Sounds Radio Receiver is on loan to you and remains the property
of Sun Sounds. The radio will be returned to Sun Sounds when it is no longer in use.

Please provide a contact person not living with you. This person may be living outside of Arizona.
They will only be contacted if your mail is returned and you have not notified Sun Sounds of your
new address and phone number.
Contact Person's First & Last Name
Contact Person's Telephone Number
I have read the information furnished and will abide by the terms set forth by Sun Sounds of Arizona.
Please enter your full name to agree to the above statement

Services Available Statewide:

FLAGSTAFF: 1300 S. Milton, #202, Flagstaff AZ 86001
Phone: 928-779-1775, Fax: 928-779-1775 (listen for the prompt, then press 9)

TEMPE: 2323 W. 14th St., Tempe AZ 85281
Phone: 480-774-8300, Fax: 480-774-8310

TUCSON: 7290 E. Broadway, #166, Tucson, AZ 85710
Phone: 520-296-2400, Fax: 520-298-6676

Arizona Braille and Talking Book Library

Arizona Braille and Talking Book Library will deliver library books and recorded material,
as well as playback equipment, free of charge. They will contact you for more information. Sun Sounds of Arizona will not share or sell information on this application.
The information will only be used as a referral to Arizona Braille and Talking Book Library where specified and requested.
Would you like a referral to the Arizona Braille and Talking Book Library?

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