Copy, paste and print the application below:

 

Honored Fellow

Membership Application

 

Any optician who is a member of OAW can apply for the HFOAA status and proudly display these initials with their professional qualifications.

 

Join now and get the remainder of 2009 for $50. 

 

LAST NAME:  ______________________  FIRST NAME:  ______________________

COMPANY:  _________________________________________________________

ADDRESS:  __________________________________________________________

CITY:  _______________________   STATE :  ________  ZIP:  _______________

PHONE #:  _____________________________  FAX#:  ________________________

E-MAIL:  ____________________________________________________________

Credit Card Information:

Name on Card:________________________________ VISA  M/C  AMEX (circle one)

Card Number:_____________________________________Exp. Date:_____________  

        Code Number (on back of card) ____________________

Please check one:

____ I am an Individual Member of OAA

____ I am a Firm Member of OAA

_X___ I am a current member of Opticians Association of Washington

                                 

Please fill out the application and mail with your $50 payment to:

Opticians Association of America

4064 E Fir Hill Drive 

Lakeland, TN 38002

OR

Include Credit Card Information and Fax to 901-388-2348