If you are an educator and you think a student could benefit from the BSBG program, please complete the form below.** Note: Parents, please do not fill out the form as you will need an educator's referral for the application.
Submit your request below and we'll get back to you.
Student's first name
Student's last name
Bow Valley/Edgemont in Calgary, etc.
Newfoundland and Labrador
Prince Edward Island
What is the child's grade level?
Your first name (educator)
Your last name (educator)
What subjects do you teach?
Your email (educator)
Share with us why you think this child/student would benefit from receiving eye care and eye wear from our BSBG program. All responses remain confidential.
How did you hear about the BSBG program?
Social network post? Ad? Word of mouth? From your School?
Should be Empty: