Procedures to Obtain Eyeglasses for a Student in Need

  1. School nurse will have parents fill out Student Information Form.
  2. The nurse and the principal will both sign the form to indicate that there is a valid need for financial aide.
  3. The nurse and principal also sign the Student Authorization Form.
  4. Send all forms to Jenny Bivans, Principal at Union Elementary School.  She serves as chairman of the Lions Club Eyeglasses Committee.
  5. Jenny will gain approval from the Lions Board, sign the authorization form, and return the form to the nurse.
  6. The nurse will give the Student Authorization Form back to the parents.  Once they have approval from the Lions, they may make an appointment with the optometrist.
  7. Parents need to take the signed authorization form with them to the optometrist. They must know that only $150 of the cost will be covered by the Lions. Zionsville Eyecare and Zionsville Family Optometry Practice have agreed to the following rates:  Single vision lenses, $50; frames, $55; and exam, $45.  If the family chooses to go elsewhere, they will be responsible for the rest.  If for some reason additional expenses are unavoidable, as in the case of bifocals, please contact Jenny Bivans and she will need to get approval from the Lions prior to purchases being made.
  8. The optometrist bills the Lions Club for the glasses.

If you have any questions about this process, please contact Jenny:

Jenny Bivans, Principal
Union Elementary School
11750 East 300 South
Zionsville, IN  46077
317-733-4007 x16999