If You Have a VR Counselor, We Can Help!

If you have a Vocational Rehabilitation (VR) counselor, they can buy the full video package (Home Study DVDs, Classroom DVDs, Student's Workbook, and Teacher's Manual) for you.

 

 

 

 

 

Please fill out the form below. Then we will contact your VR counselor for payment and send you the video package.

 

 

 

 

 

 

 YOUR CONTACT INFORMATION


Yes! I want the Complete VR "Teach Me English in ASL" package as soon as possible.

 

 

Your First Name:

 

 

Your Last Name:

 

 

Your Home Address:

 

 

City:

 

 

State:

 

 

Zip Code:

 

 

E-Mail Address:

 

 

VP Number:

 

 

Telephone Number:

 

 

 WHO IS YOUR VR COUNSELOR?

 

 

VR Counselor's First Name:

 

 

VR Counselor's Last Name:

 

 

Office Address:

 

 

City:

 

 

State:

 

 

Zip Code:

 

 

E-Mail Address:

 

 

VP Number:

 

 

Telephone Number:

 

 

Fax Number:

 

 

 Completion


Please click the "Submit Now" button below, and we will contact you and your VR counselor to send you the complete video package
 


 

 

 

 

 

 

 

 

 

 

 

 

 

Copyright © 2009 - 2010 ASL MEDIA, LLC All rights reserved.   Contact