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Lions club glasses application

Lions club glasses application 2025

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The document is an application form for eyeglasses provided by the Lions Club, specifically for residents of Newport, Toledo, Siletz, and Eddyville in Oregon. It includes sections for applicant information, insurance and financial details, authorization for disclosure of financial information, and contact information for the local Lions Club. The form aims to assist individuals in obtaining eye exams or eyeglasses through charitable support.

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Click ‘Get Form’ to open the lions club glasses application in the editor.
Begin with Section 1: Applicant Information. Fill in your first and last name, date of birth, home address, phone number, email address, and the number of people living in your household. Indicate if you are requesting an eye exam, eyeglasses, or if you have a current prescription.
Proceed to Section 2: Insurance and Financial Information. Check your insurance coverage and provide details about your monthly gross income and expenses. This section helps determine eligibility for assistance.
In Section 3: Authorization for Disclosure of Financial Information, sign and date to authorize the Lions Club to access your financial information for eligibility assessment.
Complete Sections 4 through 6 as necessary, ensuring all required fields are filled accurately before submitting the form to the designated Lions Club.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How to get a pair of free glasses?

Community Programs: Look for local charities, non-profits, or community health organizations that provide assistance for vision care. Programs like ``Vision USA or ``Lions Club may offer free or low-cost glasses. Payment Plans: Some optical shops offer payment plans that allow you to pay for your glasses over time.

Can I get money for my old glasses?

Fashion Eyewears new Trade-In Program allows you to send in your old frames to be restored or recycled, whilst earning credit to spend on your next order. At F/E, we want to do our bit in reducing waste produced by the fashion industry by giving a new life to your old or unused glasses and sunglasses.

How do I get free glasses from the Lions Club?

Assistance for eye exams, glasses or hearing aids should be requested through your local Lions Club. Local clubs determine their ability to help individuals based on their club funds availability.

How do you apply for Lions Club glasses?

Obtain the OR Lions Club Application for Eyeglasses form from the local Lions Club or their official website. Fill out the applicants personal information, including name, address, and contact details. Provide specific details about the vision impairment and the need for eyeglasses.

Are there income restrictions for Lions glasses?

Income will be no greater than twice national poverty level. No or minimal insurance coverage for vision care.

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How can I get my glasses for free?

You can get free eyeglasses from the Lions Club and Medicaid. Other agencies can be found that help low vision people who cannot afford to buy them. Also the Veterans Administration provides exams and glasses to former servicemen.

Who is eligible for Lions Club glasses?

A basic pair of single or lined bifocal eyeglasses is provided for individuals who meet a financial criteria of 200% of Federal Poverty Level, and are un- or under-insured. Lions Vision Services will pay for the costs of the glasses or equipment.

How do I qualify for free glasses?

Free NHS eye tests and optical vouchers are under 16. are 16, 17 or 18 and in full-time education (this includes being taught full-time at a school, college, university or at home) are 60 or over. are registered as partially sighted or blind. have been diagnosed with diabetes or glaucoma.