Please fill out the following information.
I hereby apply for membership in the Low Vision Section of the California Optometric Association. If accepted, I will abide by its bylaws, support its objectives and pay the established annual dues. I understand that my membership is also contingent on remaining a member in good standing with the California Optometric Association.
Membership Dues: Students receive free membership with LVRS, however they must be a student member of COA.
Fields marked with * are required.
Your form submission WILL be encrypted using SSL to ensure your privacy.