Application Form
Please use this application form to avail of the services offered by the Florida Lions Community Hearing Bank.
NOTE: THIS FORM SHOULD BE SIGNED BY THE PRESIDENT OF THE SPONSOR LIONS CLUB.
Mail the completed application to:
Lion Betty Barrera at 1833 NW 168th Ave., Pembroke Pines, FL 33028 or
E-mail to: bettyalidab@hotmail.com
Lions Clubs sponsoring a case are requested to assist by donating to the Florida Lions Community Hearing Bank for a fraction of the cost of hearing aids. Florida Lions Community Hearing Bank is funded by the generous donations of the Lions Clubs of District 35 and by individuals and organizations who wish to make a difference by helping those who are less fortunate.