This is to authorize up to and not exceed ninety dollars ($90) for an exam, lenses and frames for a student under eighteen (18) years of age. The sight program will pay for glass lenses and a select group of plastic frames only.

Additional cost exceeding the ninety-dollar amount such as: tinted lenses and metal frames, will need to be provided by Parent/Legal Guardian.

This program is not intended for a yearly maintenance program for eye care.

*Individual cases will be handled on special needs basis.

Thank you for your service, interest and consideration - and most of all, your fine-cooperation with the ROLLA LIONS CLUB SIGHT CONSERVATION COMMITTEE.

Note to Applicant: Normally a two (2) year interval between services is required. Applicants MUST make their own appointment with InVision Eye Care, Dr. Falkenhain or Wal-Mart Vision Center.