Nomination Form

Please review the nomination descriptions and criteria if needed here.

Deadline for submissions is March 1!

Nominee*

Local Society of Nominee*

Nomination for:*

Virginia Optometrist of the Year Award

Distinguished Achievement Award

Meritorious Service Award

Vanguard of the Year Award

Keyperson of the Year Award

Society Project of the Year Award

The noteworthy service upon which this nomination is based follows (Please refer to the award descriptions and criteria):*

Name of active member or Local Society making nomination:*

Nominee's CV

VOA Awards Nomination Form