Veteran Vision — Participant Interest Form
Share your contact details and eligibility interest for screening only—submission doesn’t guarantee selection or a device.
First name
*
First Name
Last Name
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you confirm that you are a U.S. military veteran who meets the current Meta/TechSoup program criteria?
*
Yes
No
Branch of service
*
Marine Corps
Army
Navy
Air Force
Space Force
Coast Guard
Other
Service component
Active Duty
National Guard
Reserve
Other/Not sure
Which best describes your current vision status?
*
Blind
Low vision / visually impaired
Severe vision impairment
Not sure
How did you hear about Veteran Vision?
*
Marine Corps League
VFW
American Legion
DAV
Blinded Veterans Association
Veterans Against Diabetes
Other
If selected, are you willing to attend hands-on training and follow-up?
*
Yes
No
Need more information
Verification
Veterans Against Diabetes may request appropriate documentation later to confirm veteran status and qualifying vision-related eligibility, including veteran-status documentation and vision documentation from a qualified source if needed.
Which verification document(s) could you provide if requested later?
*
DD-214
VA identification card
Driver's license showing corrective-lens/glasses restriction
Other official veteran documentation
Other vision-related documentation
Prefer to discuss with VAD
A corrective-lens restriction on a driver’s license does not by itself establish blindness or low-vision eligibility; VAD will review documentation according to final program requirements.
Submit Interest Form
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