telephone service / landline telephone service / telecommunication devices / Stolen equipment / Bank statements / recent telephone bill / telephone services / telephone number appearing / telecommunications services / telecommunication equipment / high speed internet / /
Organization
Social Security Administration / Captioned Phone Ensemble / Temple University / Name_______________________________________ Title_______________________________ Agency / 13th Street Student Center / TOTAL MEMBERS IN FAMILY UNIT / PA Public Utility Commission / TDDP Program Coordinator Institute on Disabilities / Department of Public Welfare / Institute on Disabilities / PA office of Vocational Rehabilitation / / /
Position
representative of a qualified state agency / licensed physician / audiologist / licensed audiologist / Social Worker / Counselor / licensed speech-language pathologist / Administrator / current driver / physician / audiologist / speech-language pathologist / licensed physician / OR representative of a qualified agency / audiologist / speech pathologist / /
ProvinceOrState
Pennsylvania / State________________ Zip__________________ County / /
Application Commonwealth of Pennsylvania’s Telecommunication Device