Forms

Use this form to enroll or update your information for Automatic Dues Payments.

Back of Dues Statement 2012

Back of Dues Statement 2013

Use this form to report a new or reinstated optometric educator member, a current member requesting a change in status back to optometric educator.

Use this form to request your membership category be changed to Educator/Faculty.

Request for Dues Adjustment (PDF Form -- Print or Email)
Use this form to request a dues adjustment if you are having financial difficulty with your dues payment.

Project Keep
If you are a new licentiate (having been licensed 10 years or less) and hold a society or COA leadership position use this form to request Project Keep status. Your society President will need to approve your application prior to submitting the form to the COA for processing. Click here for more information about Project Keep.

Sample Speaker Contract: This is a sample Speaker Contract Template for local society speaker events.

Sample Speaker Disclosure Statement: The Association of Regulatory Boards of Optometry (ARBO) has implemented guidelines to appropriately manage industry relationships in support of CE activities to ensure transparency, fair balance, content free of commercial bias and an effective system of oversight. This form goes along with the speaker contract.

Request for CE Approval Form: When requesting approval for continuing education credit for a California Optometric Society event use this form and send into COA.

Attendee Verification Form: Upon completion of your continuing education program, this form must be submitted to the California Optometric Association, along with a list of attendees with their license numbers. No fee is required; however, please note that the COA will only transcribe continuing education hours for COA members.

Society Proof of Attendance Certificate: This is an example of what to provide event attendees after attending a local society CE approved event. The attendee will keep this in their records as proof of attendance.

Volunteer & Travel Policy & Procedure

Volunteer Expense Report