CNIB Foundation Virtual Vision Mate Sign Up Form

Thank you for your interest in CNIB Foundation Virtual Vision Mate Program!

In order to complete your registration, we need to get to know you a bit better. Please be assured all information gathered is private and confidential.

Please note: Due to the volume of applications, it may take a few days for us to respond. We'll be in touch soon!

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Declaration and Submission

Please read the following declarations carefully prior to checking the box stating that you agree to the outlined declarations and submitting your application.

  • I declare all the information provided on this form and in any other accompanying documents is complete and true in every respect.

  • I understand failure to completely and truthfully answer the questions asked of me, when discovered, will constitute grounds for immediate rejection of my application.

  • I understand that all personal information which become part of this application will be regarded as confidential pursuant to the Freedom of Information and Protection of Privacy Act.

For assistance please contact us at our Contact Centre: 1-800-563-2642.