YES! I WANT TO PROMOTE AWARENESS AND TREATMENT OF VISION DISORDERS

Enclosed, please find my donation for membership in Vision Awareness of Washington, for:

Name: _____________________________________

Address: ____________________________________

___________________________________________

Phone: (____)______________________

Willing to volunteer for the following activity: ___________________________________________

Donations are needed to help keep this Web site alive!

Please mail this form with your donation and/or regarding whether you would like to volunteer, to:

Vision Awareness of Washington
Attn: Kathy Graves
12618 SE 75th Pl.
Newcastle, WA, U.S.A. 98056