BrightEyesApplication

Bright Eyes Program - Application
The “Bright Eyes” program entitles qualified applicants, assistance toward one pair of eyeglasses per child, per school year.

Eligibility:
1. All dependents of Active Duty Service members and Department of Defense employees, infant up
to 12th grade students.
2. Sponsor and family members must be assigned to and live within the Hohenfels community.
3. Dependents or their family members do not have to be members of the HCSC to participate.
4. Dependents can only receive one credit through the “Bright Eyes” Program within the current school year. The school year shall be defined as the calendar year pre-prescribed by DODEA Europe.

How it Works
1. The applicant needs to have his/her vision screened and obtain a prescription.
2. The applicant purchases a pair of prescription glasses.
3. The applicant will turn in an application form to the HCSC within thirty (30) days
of purchase, including all required documentation.
4. The HCSC will issue a credit of up to $50.00, not to exceed the purchase price,
towards a pair of glasses, until funds are exhausted.
5. Checks will be issued by the 10th of the following month and will be mailed to the applicants.
Sponsor Name *

First Name Last Name
Sponsor Rank *
Sponsor Unit/Team *
Parent Guardian Name (if other than sponsor)

First Name Last Name
Email Address *
example@example.com
Phone Number *
Please enter a valid phone number.
CMR Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Dependent Applicant Name *

First Name Last Name
Dependent Applicant Grade *
Dependent Applicant DOB *

Month Day Year
Date
Please upload a copy of dependent applicant's current prescription. *

Cancel of
Please upload a copy of your receipt for the purchased prescription glasses . *

Cancel of
Should be Empty:

Bright Eyes Program - Application