Bright Eyes Application

Bright Eyes Program Application

Please follow the steps below to apply for the Bright Eyes program:

Complete the application form on the right. Once submitted, the form will be forwarded to the School Liaison Officer (SLO), who will contact you to coordinate LES submittal.
Once the SLO verifies your income and the number of dependents, they will send an email with this information to the Bright Eyes POC.
Upon receipt of verification, the Bright Eyes POC will determine qualification against the Income Eligibility Guidelines (IEGs) established by the US Department of Agriculture (USDA) for the Free Lunch Program. If the servicemember qualifies, the Bright Eyes POC will issue a qualification memo via email to the servicemember.
Servicemember or spouse must bring the memo to the KMCC Optical Shop to receive a credit of $89.95 toward a pair of glasses. This is good for one pair, per child, per school year.*

*A school year is defined as the period from July 1, 2023 through June 30, 2024.

Questions? Please email brighteyes@klsa.org.

SPONSOR INFORMATION

Sponsors Name

First Name

Last Name

Sponsors Unit

Sponsors Rank

How many total members are in the household including the sponsor?

Branch of Service

Sponsors Email

DEPENDENT INFORMATION

Please list the full names of your dependents who need glasses.

Dependent #1 Name

First Name

Last Name

What DoDEA school does this dependent attend? If none, please list the home school or Germany school.

Dependent #2 Name (if applicable)

First Name

Last Name

What school does this dependent attend?

Dependent #3 Name (if applicable)

First Name

Last Name

What school does this dependent attend?

Dependent #4 Name (if applicable)

First Name

Last Name

What school does this dependent attend?

Dependent #5 Name (if applicable)

First Name

Last Name

What school does this dependent attend?

How did you hear about our program so we can better target where we publish info?

PLEASE NOTE: KLSA is an all-volunteer organization with limited funding. Our mission is oriented to giving based on need and we try to help as many families as possible. Thank you for your understanding.