Rutherford and Polk Eye Exams

• The following eye exams are only available for students that have completed or are currently enrolled in driver's education class, and residing in Rutherford or Polk County. All others will not be accepted. **Dates will be updated as scheduled

• Students attending R-S Central High School can also make an appointment with Mr. Sherburne (room 237) to complete their eye exam.

• Students may attend either Rutherford or Polk

• YOU MUST COMPLETE REGISTRATION IN ORDER TO ATTEND

YOU MUST HAVE PAGE 1 OF THIS FORM, OLDER FORMS ARE NO LONGER ACCEPTED