Award: Society of the Year 2019

Submission Deadline: October 10, 2019

Society: *

Society President Name: *

Society President's Phone: *

Society President's Address: *

Number of Society members: *

Name of person completing this nomination form: *

Entries will be evaluated according to a point system allocated to three principal areas. Only list activities of your society, not those of individual members.

Community Involvement (60 points)

Describe any programs or activities your society has conducted to get its members involved in the local community. *
(Maximum characters: 2000)
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Describe what your society has done to shape the delivery of vision and eye care to the community (local government health agencies). *
(Maximum characters: 2000)
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List and describe the public service projects your society has done to promote vision/eye care. *
(Maximum characters: 2000)
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Describe and list specific examples of what your society has done to improve the public’s awareness of proper vision and eyecare. *
(Maximum characters: 2000)
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Describe what your society has done in the area of relations with other health care providers. *
(Maximum characters: 2000)
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Describe any other area your society has been involved with this last year that relates to community involvement. *
(Maximum characters: 2000)
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Legislative Activities (45 points)

Describe any programs or activities your society conducted this year to increase member involvement with local, state, and federal legislators. *
(Maximum characters: 2000)
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Describe your society’s involvement in optometric political action committees, including what percentage of your membership is participating in Cal-OPAC, AOA-PAC, and LSCOA-PAC. *
(Maximum characters: 2000)
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List the fundraisers, visits to field offices, help on campaigns or letter writing on key issues that your society participated in for each of your state legislators. *
(Maximum characters: 2000)
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Society Improvement (45 points)

Describe the area in which your society improved the most this year: *
(Maximum characters: 2000)
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Describe what your society has done to increase member attendance at local meetings: *
(Maximum characters: 2000)
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Describe what your society has done to increase membership: *
(Maximum characters: 2000)
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List and describe the new programs or projects your society has initiated this year: *
(Maximum characters: 2000)
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