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Active Member Application

Overview
Academy membership comes with a wide range of benefits.

You are eligible to apply for membership as an active member if:

  • You hold a degree of Doctor of Medicine, Doctor of Osteopathy or an equivalent medical degree; and
  • You hold a valid and unrestricted license to practice medicine in the United States or the country in which the practice of medicine is regularly conducted.

A physician who holds a degree of Doctor of Medicine, Doctor of Osteopathy or equivalent medical degree as determined by the Board of Trustees, who holds a valid and unrestricted license to practice medicine in the United States, Canada or the country in which the practice of medicine is regularly conducted and who has satisfactorily completed an entire program of formal residency training in ophthalmology of at least three (3) years duration, shall be eligible to apply for membership as an active member.

To apply for membership:

  • Fill out the application online (PDF 2.2 MB), using the tab key to move from field to field.
  • Print the application.
  • Obtain all necessary signatures.
  • Sign the application and include the application fee payment.
  • Mail or fax the completed application to Member Services.

If you are unable to use the fillable PDF version of the application, you can also download the form (PDF 2.2 MB) and fill it out by hand.

Application Fee: $850 (USD) effective Jan. 1, 2010
Application DeadlineJuly 15, 2010

If you have questions or prefer to have an application mailed to you, contact Member Services by phone 415.561.8581 or fax 415.561.8575.

 
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