District 33Y EyeMobile Reservation Request Form

This page is for use by Lions, Lioness, and Leos Clubs of District 33Y to reserve the EyeMobile for events. All other should contact their local Lions. Lioness or Leo Clubs regarding the use of the EyeMobile at functions.

Have questions? Download and read our FAQ

For other questions regarding the EyeMobile, contact the EyeMobile Board: http://www.lions-33y.org/forms/EMMessage.html

Reserving the EyeMobile, as easy as 1 - 2 3- 3:

Step 1: Ensure the EyeMobile is available for the the Date(s) you want it: Check the EyeMobile calendar at http://www.lions-33y.org/testing/33Y-eyemobile.html#calendar.

Step 2: Arrange for a driver for the day(s) in question. http://www.lions-33y.org/forms/33YEMDriversContactList.pdf (No Driver - No Reservation.) It is the responsibility of the reserving club to arrange a driver for the EyeMobile from the list of qualified drivers.

Step 3: Submit the following Reservation Request Form. As an alternative, you can download a paper reservation form to mail in: http://www.lions-33y.org/forms/District33YEyeMobileReservationRequestForm.pdf or

If you don't hear back within a couple of days, contact the EyeMobile Board at http://www.lions-33y.org/forms/EMMessage.html

Request: *	I would like to reserve the EyeMobile for a specific date. I would like to reserve the EyeMobile and have several potential dates I would like to change my existing reservation. I have questions, please help! Other
Club Name *
Primary Contact Name: *
Street Address:
City:
State:
Zip:
E-mail Address: *
Home Phone:
Work Phone:
Fax Number:
When is the best time to contact you?	Morning Afternoon Evening
What is the best means to contact you?	Phone E-mail Fax
Reservation Date
Time of Use	Start Time End Time This is when it will be in the parade, or open for screening.
Driver's Name* No Driver - No Reservation	(You have contacted this driver and he/she agrees to drive!)
Physical location where the EyeMobile will be located
Reason for the request/ Description of Event at which EyeMobile will be used.
Message:


*Required

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Credits:

Page maintained by Lion Dennis Waller (Northampton Lions Club)
Lions Logo courtesy: The International Association of Lions Clubs.
Multiple District 33 Map: PDG Lion Paul Viano. Conversion by Lion Al Porter. Modified into an imagemap by Lion Dennis Waller

Last Updated 7/8/2007