Champion Sign-up

YES, I WOULD LIKE TO BE ADDED AS A 'CHAMPION' FOR THE 2023 CHALLENGE!
As a Champion, you will be sent a link to access the 2023 World Sight Day Challenge digital materials such as a fundraising guide, social media & email assets, and more!
My practice/company/school has already registered for the Challenge*
- Yes
- No
**If you answered 'No' above because your practice/company/school has not yet registered, please use this form instead: https://givingsight.org/wsdc/register-for-fundraising-choose-category/
I am part of:*
- Optometry Practice
- Company
- School
GENERAL DETAILS
Practice/Company/School/Organization Name*
Your Title (ie: Dr., Mr., Mrs., Ms., etc)
Your Name*
Your Job Title (if applicable)
Your Email*
Your practice/company/school/organization address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone

YES, I WOULD LIKE TO BE ADDED AS A 'CHAMPION' FOR THE 2023 CHALLENGE!