WSDC Registration - Optometry Giving Sight

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I am registering(Required)

An optometry practice

A business or organization

An optometry student group

Country(Required)

United States

Canada

Other

Practice name as you would like it to appear publicly(Required)

Business/organization name as you would like it to appear publicly(Required)

Name of school as you would like it to appear publicly(Required)

Name of student organization as you would like it to appear publicly(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Address(Required)

Street Address Address Line 2 City Province Postal Code

WSDC 2026 Point Person(Required)

Prefix First Last

Job Title(Required)

Email(Required)

Share your fundraising goal here!(Required)

Who else in your organization should receive World Sight Day Challenge related emails? Please list their names and email addresses.

We have gone digital this year but should you need a kit mailed to you, please checkmark here.

Yes, I would like a kit mailed to me

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