Volunteer Application Form

 

If you are an eye care professional, please complete this form instead.

At this time, all new volunteers are required to be fully vaccinated for COVID-19 prior to volunteering.

Please enable JavaScript in your browser to complete this form.
Home Address
I am interested in: (select all that apply)
I am a: (select any that apply)
I am proficient in speaking the following lanaguages: (select all that apply)
Documentation of Hours Needed:
Emergency Contact Name