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Sierra Services for the Blind and Visually Impaired offers full services, at no charge, to clients in the foothill communities of Nevada and Placer Counties and beyond.

 We help blind and visually impaired individuals

stay in their homes and out of institutions.

Membership Application

Name: ____________________________

Address: __________________________

City: ______________________________

State/ZIP: __________________________

Phone: ____________________________

E-mail: ____________________________

Please check those that apply:

• $10 membership (minimum annual)

• $__________Other Donation to:
  
  _______________________________

• $__________In Memory of:
  
  Name: _________________________

• I want to be a volunteer driver.

Please print out and mail this form with your check to:

Sierra Services For the Blind
546 Searls Avenue
Nevada City, CA 95959

Or, to use your credit card, call (530) 265-2121.