STORIES OF SUCCESS

Founded several years ago, Sight for Students was created by Vision Service Plan to help needy children obtain vision care. Various organizations have committed to make the program available to the youth served throughout the nation.

Since you helped identify students for the award, we also request that you report on students who were positively affected by the program. Often, vision correction can make a world of difference to a child's learning ability. We would like to share any success stories with VSP's staff and doctors, and with yourorganization as a whole.
We recognize the importance of patient confidentiality. Therefore, in filling out the form below, we are not interested in knowing the student's name-Just the story of success. If, for some reason, we become interested in the student's story for external publicity at a later date, we will contact you and the family first for clearance. Thanks for your assistance!

Your Name:_____________________________________________________________________

> Your Phone Number:______________________________________________________________

Your Organization:________________________________________________________________

Location:_______________________________________________________________________
Story of Success (use opposite side or separate sheet if necessary):
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
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Please return to:
Vision Service Plan, Attention: Mary Kearney, P.O. Box 997100, Sacramento, CA 95899-9989 Phone: (800) 852-7600, Ext. 5156 Fax: (916) 858-5388

See also:
     Partnership between head Start and Vision Service Plan