Email address:

First Name

Last Name

Organisation

Province

Do you suffer from corneal blindness? No Yes

Do you suffer from advanced keratoconus? No Yes

Do you require a cornea transplant? No Yes

Are you an optometrist or ophthalmologist? N/A Optometrist Ophthalmologist

Are you a social worker or low vision practitioner? N/A Social worker Low vision practitioner

What information would you find inspiring & exciting in communications from Eyes2Eyes?

Medical No Yes

Successful stories from our beneficiaries No Yes

Our advocacy work No Yes

Thought leadership No Yes

In alignment with South Africa’s POPI Act, we respect your privacy and will never share your personal information without your consent. We promise not to spam you – only to send you relevant and inspiring updates, stories, and opportunities that matter to you. Your data will be processed securely as per our Privacy Policy and used solely for the purposes of our communications.