Survey - Hampton Roads 2013 - materials order

1.

Question - Not Required - I've got a lot of people ready to register for the Walk! Please send me Registration Brochures:

2.

Question - Not Required - I'm ready to spread the word about the Walk! Please send me flyers to hang all over town:

3.

Question - Not Required - I want to encourage my friends and family members to join me in the Walk. Please send me additional Team Captain folders:

4.

Question - Not Required - I want to help with the sponsorship campaign and reach out to potential sponsors. Please send me sponsorship packets:

5.

Question - Not Required - Local businesses have a special opportunity to spread the word about VisionWalk, increase public awareness, and help FFB's research efforts by promoting the "POP Eye Program" throughout their store. This fun and profitable promotion typically runs for 4 weeks. Store cashiers simply ask customers at the point of purchase to buy a paper POP Eye for $1.00 to help support the Foundation Fighting Blindness. The customer then signs his/her name on the POP Eye and store employees post the POP Eye throughout the store. Yes, I'd like to help bring the POP Eye Program to my local community. Please send me information flyers.

6.

Send my order to the address below:

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Name:

Title	First Required	Middle Required	Last Required

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Street 1: Required

Street 2:

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City/State/ZIP:

City Required	State Required	ZIP Required

Phone Number:

If you respond and have not already registered, you will receive periodic updates and communications from Foundation Fighting Blindness.

Remember me the next time I log in. What's this?

*7.

Question - Required - My email address is:

8.

Question - Not Required - I still have some questions about the Walk: (Please enter your questions and contact information in the box below)