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Become a Partner Form

Complete this form to apply to become a VSP® Eyes of Hope® gift certificate partner.


As a partner, you’ll be able to request VSP Eyes of Hope gift certificates to distribute to adults and/or children who qualify. To be approved, partners must be an educational institution, registered as a 501(c)(3) nonprofit, or an optometric association.

If you’re affiliated with any of our national partners or have received VSP Eyes of Hope gift certificates in the last 12 months, there’s no need to re-apply. Visit partners.vspeyesofhope.com, select your organization, and click the Request Gift Certificates button.

All fields are required unless noted.

Organization Information

Is your organization recognized as a 501(c)(3) charitable organization?
Does your organization have a connection to vision care?
What age groups does your organization serve? Select all that apply.
Does your organization have a focus on specific populations in need?
Were you referred by the VSP Eyes of Hope mobile clinics team due to a declined event request?

Primary Contact Information