Indiana Optometric Association

Distinguished Service Nomination Form - Indiana Optometric Association

DISTINGUISHED SERVICE TO OPTOMETRY: The award(s) shall be presented only to IOA members for long-time service rendered to the profession of optometry performed within the state association or for an outstanding current record which merits recognition but does not meet the AOA "O.D. of the Year" award standards. Only societies and the Executive Committee will be authorized to make nominations. The stature of the Distinguished Service to Optometry must be maintained so that it is meaningful, but not to be given out indiscriminately for mere PR reasons. The number of awards to be given will be left to the discretion of the Awards Committee. The award(s) may be presented each year. The Awards Committee is to decide the winner(s) of this award, subject to review by the Executive Committee. The criteria are to be brief and selective, but contain room for interpretation by the Committee.

First Name *

Last Name *

Email *

Are you making this nomination on behalf of a local society? *

Yes

If yes, please indicate Society name

Please provide the name of your nominee for the Distinguished Service Award

Nominee's City and State

Nominee's Email

Nominee's Phone

Please describe the long-time service to the profession or outstanding current service in which the nominee has engaged

Additional comments