Heartland Lions Eye Banks  
Heartland Lions Eye Banks
Heartland Lions Eye Banks  
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Are you interested in sharing the story of your cornea transplant and becoming a Sight Ambassador? Please fill out the form below and a representative from the Heartland Lions Eye Banks will contact you about upcoming volunteer opportunities in your area.

First Name Last Name
Email:
Address
City State ZIP

Year of Transplant (If more than one, list most recent)

I would be interested in the following Sight Ambassador opportunities (please check one or more):
Volunteering at the Eye Banks' fundraising events
Speaking at events about my experience as a cornea transplant recipient
Sharing my "Gift of Sight Story" with the Eye Bank for use in online, print and video publications.
Participating in annual National Eye Donor and National Donate Life Month events in my area.