Application for Student VOA Membership

TO THE BOARD OF TRUSTEES OF THE VIRGINIA OPTOMETRIC ASSOCIATION
 
Being a student in an acreddited Optometric College, interested in further professional and technical advancement of my profession and being in complete accord with the purposes and objectives of the Virginia Optometric Association and its programs, I do here by voluntarily apply for membership. 

Page 1/6 - Demographics

    

Page 2/6 - Contact Information

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Page 3/6 - Education

Page 4/6 - Education

Page 5/6 - Preferences

Page 6/6 - Certification




4461 Cox Road
Suite 110
Glen Allen, VA 23060

Phone: (804) 643-0309
Fax: (804) 643-0311

All doctor members of the Virginia Optometric Association are licensed to practice Optometry in Virginia.
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