Eye Care Application
Eyecare Application-Intake 2014 (click to open)
The funds raised through the Save-An-Eye All-Star Football Game directly benefit individuals who could not afford a pair of glasses otherwise. We do not fund contact lenses. Completion of this application allows us to qualify you for aid and calculate the amount of funding permissible.
Rules of funding:
- Children first – full funding in most cases regardless of income
- Adults second – sliding fee based on household income
- Eye health related projects – only after first two needs are met
- Individual making less than $29,000 / yr
- Household of 3 earning less than $49,500 / yr
- Family of 4 bringing in less than $59,600/ yr
- Less than $69,700 for 5, $79,900 for 6, and so on
Where can I obtain my eyewear?
- Through The Sight Center of NWPA, all materials and labor are discounted by the sliding fee scale
- Through your regular eye doctor, the Lions Club of Erie will fund up to $65 towards your eyewear based on the sliding fee scale
How do I obtain the aid?
- Mail your application and financial records to:
- Once information is reviewed you will be contacted