Are You A Vision Hero?

We are seeking inspiring young people who have overcome their vision challenges despite being told they have limitations that may hold them back from achieving their dreams. These remarkable Vision Heroes mentor and motivate others to persevere and reach their personal goals-whatever they may be! Check here for new profiles. By spotlighting new Vision Heroes regularly, we hope to encourage young people to realize their talents and reach their full potential in life!

Vision Hero Program Participant Application 2

About The Vision of Children Foundation

The Vision of Children Foundation (VOC) is dedicated to curing hereditary blindness and other vision disorders while enhancing the lives of visually impaired individuals and their families. For over 30 years, VOC has been at the forefront of funding groundbreaking research aimed at finding cures for hereditary childhood blindness and genetic vision disorders, providing hope to families facing these life-altering challenges. The Vision of Children Foundation’s Vision Heroes program, honors young people who have overcome their vision challenges and are living extraordinary lives. We identify and share the stories of inspiring young people who have overcome their vision challenges despite being told they have limitations that may hold them back from achieving their dreams. These remarkable Vision Heroes mentor and motivate others to persevere to reach their personal goals-whatever they may be. By regularly spotlighting new Vision Heroes, we hope to encourage young people to realize their talents and reach their full potential in life.

Applicant / Nominee Information

Applications for Vision Heroes are reviewed regularly by an Advisory Board. Please fill out this form if you would like to nominate a young person (under 21 years of age) for this program.

Section 1: Recommender Information (If Applicable)

(For third-party nominations only)

Full Name

First Name

Last Name

Email Address

Phone Number

Country

(###)

###

####

Relationship to Candidate

Section 2: Candidate Information

Full Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthdate

MM

DD

YYYY

Diagnosis or description of candidate's eye condition:

(Please provide a brief summary of the candidate's visual impairment)

Why would this candidate make an inspiring Vision Hero?

(Include details about the candidate’s talents, achievements, and how they have overcome their vision challenges.)

Section 3: Parent/Guardian Information (For Minors Only)

Parent / Guardian Full Name

First Name

Last Name

Parent / Guardian Email Address:

Parent / Guardian Phone Number:

Country

(###)

###

####

Section 4: Consent and Waivers

Parental/Guardian Consent (If Candidate is Under 18)

As the legal guardian of the above-named candidate, I hereby provide my consent for my child to participate in the Vision Heroes Program. I further give permission for The Vision of Children Foundation to use my child’s name, likeness, and story in any media materials (e.g., promotional videos, social media, press releases) related to the program. Data Privacy and Protection By submitting this application, I understand that all personal information provided will be securely stored and used solely for the purpose of evaluating candidates for the Vision Heroes Program. This information will not be shared with third parties without prior consent, in accordance with the California Consumer Privacy Act (CCPA) and, where applicable, the General Data Protection Regulation (GDPR).

Yes

Parent/Guardian Full Name:

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

First Name

Last Name

Date

MM

DD

YYYY

Health Information Consent

I acknowledge that any medical information provided (e.g., vision diagnosis) will remain confidential and will be used only for the purpose of evaluating eligibility for the Vision Heroes Program.

Yes

Signature of Candidate (or Parent/Guardian if under 18):

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.

First Name

Last Name

Date

MM

DD

YYYY

Hear from our inspiring and remarkable Vision Heroes!

See all of our Vision Hero Stories on our YouTube Channel!

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Project Vision Aid

Are You A Vision Hero?

Hear from our inspiring and remarkable Vision Heroes!

See all of our Vision Hero Stories on our YouTube Channel!

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