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Home
Membership
Membership
Dues Scale
Calendar
Seminars / CE
Seminars / CE
Indiana Optometry CE Requirements
About Us
About Us
Mission and Vision
History
Awards
Awards Criteria & Nomination Forms
Officers
Trustees
IOA Society Presidents
IOA Society Map
Staff
Disclaimer and Privacy Notice
Advocacy-PAC
Advocacy-PAC
Current Legislative Session
Legislator Finder
Senate & House Committees
Doctor Resources
Classified Ads
Sponsorship
Find A Doctor
Patient Resources
Contact Us
Member Login
Outstanding Service in the Public Interest Nomination Form - Indiana Optometric Association
OUTSTANDING SERVICE IN THE PUBLIC INTEREST: This award is bestowed upon an individual outside the profession who has done something to further the cause of proper eye care for the public. This award has typically gone to someone in the political areas, professions, or the news media. The award serves to recognize their acts for the visual welfare of the public.
*
- Required Field
First Name *
Last Name *
Email *
Please provide the name of your nominee for the Outstanding Service in the Public Interest Award
Nominee's City and State
Nominee's Email
Nominee's Phone
Please describe the service to the visual well-being of public in which this individual has engaged
Additional comments
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