Application Form
Please use this application form to avail of the services offered by the Florida Lions Community Hearing Bank.
NOTE: THIS FORM MUST BE SIGNED AND ACCOMPANIED BY HEARING TEST IF AVAILABLE, TAX RETURN OR PROOF OF INCOME/EXPENSES.
Mail the completed application to our Case Coordinator.
Lion Betty Barrera at 1833 NW 168th Ave., Pembroke Pines, FL 33028 or
E-mail to: bettyalidab@hotmail.comLions Clubs sponsoring a case may assist by donating to the Florida Lions Community Hearing Bank.
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.