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Free Eye Exam and Eyeglasses Application

Click the appropriate link below.

Patient Care Application 2017-18 English Fillable PDF

LEAP Application 2017-18 English Fillable PDF

LEAP Application 2016-17 Spanich PDF

Roar! Application 2017-18 Spanish PDF

Roar! Application 2017-18 English Fillable PDF

Patient Care Application 2017-18 Spanish PDF

Patient Care Application 2017-18 Espanol PDF

Fill out the application and Send to 

Junction City Lions Club
c/o John Reerslev
29388 Dane Lane
Junction City, OR 97448

If you have questions, please call John Reerslev @ 541-554-4274

Free Eye Glasses Applications also availabe at

Junction City Vision Center
770 Greenwood St.
Junction City, OR 97448

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