Proclamation Submission Form

Eye Donation Month State and City Proclamation Submission Form

Please complete the short form below and share a copy of your state and/or city proclamation with EBAA. This proclamation and others from member eye banks will become a part of EBAA historical records.

If you have any questions, please contact Yolanda Raine.

Eye Donation Month State and City Proclamation Submission Form

  • Name
  • Eye Bank
  • Email
  • Phone
  • Date Received
    Date Format: MM slash DD slash YYYY
  • Copy of Proclamation
    Accepted file types: jpg, gif, png, pdf, word.