Camden Eye Center Donation Form
1. Please print this page.
2. Please specify the aspect of the Camden Eye Center you wish to fund by selecting from the choices below.
Amblyopia/Lazy Eye Screening and Remediation Program
Adult and Senior Eye Care Programs
Sight First for Kids Program
General Operating Fund
3. Fill out your contact information:
Organization __________________________
Name __________________________
Street Address __________________________
Apt. or Suite __________________________
______________
City		 ______
State		 __________
Zip
Email Address __________________________
4. Mail this donor form with your check made payable to:

Camden Eye Center
400 Chambers Avenue
Camden, NJ 08103