Pennsylvania Optometric Association, American Optometric Association & Local Society
Please return completed application to POA, 218 North Street, Harrisburg, PA17101. The POA will forward a copy of this application to your local society and the AOA, if applicable. If you have any questions, please contact the POA office at (717) 233-6455 or email . For additional information, please visit .
Gifts and dues payments to the POA, AOA and local societies are not deductible as charitable contributions for federal income tax purposes; however, they may be deductible as business expenses under other provisions of the Internal Revenue Code. Consult your tax advisor.
DateFull Name
AOA Retired Membership Classification POA/Local Societies Retired Membership
(Please choose preferred option for AOA) POA Retired with Benefits (20% dues obligation)
With Benefits ($100 annual dues) Local Societies (varies)
Without Benefits (no dues)
Home Address
County
Phone
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MEMBER BULLETINS VIA EMAIL: In addition to individual association-to-member correspondence, we will periodically send you Member Bulletins containing legislative and regulatory alerts as well as information on eye care benefits, clinical care, quality management, pediatric programming, continuing education and other time-sensitive news. Member Bulletins are POA-to-member communications only; recipients cannot reply to or send messages. If you do not wish to receive Member Bulletins via email, please double-click to check here.
Date of Birth / PA License Number
* AOA and POA eligibility criteria appears on the reverse of this page.
I certify that I am eligible for Retired Membership as outlined in the AOA and POA By-Laws, and understand that I must recertify my eligibility annually.
Signature of Applying Member ______
RETIRED MEMBERSHIP ELIGIBILITY
ELIGIBILITY CRITERIA: Pennsylvania Optometric Association
POA BY-LAWS: ARTICLE II – Membership
Section 14. Retired Membership
(a)Retired Membership is granted a doctor of optometry who is no longer engaged in compensated optometrically-related activities, is at least fifty-five (55) years of age, not eligible for Life Membership, and whose status is certified annually by the member.
(b)Retired Members shall be considered in accrediting any affiliated society’s delegate votes in the House of Delegates.
(c)Retired Members shall pay dues in accordance with these By-Laws;
(d)Retired Members shall have the privilege of the floor in the House of Delegates;
(e)Retired Members may not hold elective office in this Association.
POA BY-LAWS: ARTICLE VII – Dues
Section 1. General Provisions
(c)The annual dues for Retired Members shall be 20% of the dues of an Active Member.
ELIGIBILITY CRITERIA: American Optometric Association
AOA BY-LAWS: ARTICLE I – Membership
Section 1. Classification and Qualifications; C. Affiliate Membership Classifications.
8. Retired Members.
An optometrist meeting the qualifications set forth in Article I, Section 1, Paragraph A who is at least 55 years old on January 1 of any membership year and who no longer receives compensation for optometrically related activities shall be eligible for classification as a Retired Member of this Association for that membership year provided that the optometrist is a member in good standing of the Association at the time he or she first becomes eligible for classification as a Retired Member. A Retired Member may affiliate through AFOS provided that the member meets the requirements under Article I, Section 1, Paragraph A.2(d).
Individuals eligible for classification as a Retired Member have the option to pay dues as set forth in Article I, Section 2, Paragraph C.8. Retired Members electing to pay dues (known as Retired Members with Membership Benefits) will receive membership benefits and will be entitled to membership rights as set forth in these Bylaws. Notwithstanding any provision to the contrary, Retired Members electing not to pay annual dues (known as Retired Members without Membership Benefits) will be members of this Association in name only, ineligible for membership benefits and rights, and will not be counted among the members used to determine delegates for affiliated associations under Article III, Section 3, Paragraph A.
AOA BY-LAWS: ARTICLE I – Membership
Section 2. Dues; C. Affiliate Membership Dues.
8. Retired Members must pay annual dues of $100.00 to be eligible for membership benefits and rights as set forth in these Bylaws and to be counted among the members used to determine delegates for affiliated associations under Article III, Section 3, Paragraph A.