Pediatric Eye Ambassadors

Name(Required)

First Last

Email(Required)

Phone(Required)

Are you a(n):(Required)

Undergraduate Student

Medical Student

Resident

Hidden

Are you currently a medical student?(Required)

Yes

Please reach out to us at acs@aapos.org for other ways you can help promote All Children See! Thank you for your interest.

What school do you attend?(Required)

What state do you reside in?(Required)

What year in school or residency are you?

Signature(Required)

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