Form EC2 - D - Page 3

CERTIFICATE OF IDENTITY

(EC Nationals)

To: General Optical Council, 41 Harley Street, London W1G 8DJ

THE FOLLOWING CERTIFICATE SHOULD BE SIGNED BY:

An authority recognised by the General Optical Council for the Applicant's Member State (a list of those authorities is shown on the back of this certificate) or the General Optical Council if you present this form in person

I certify:

(a) that [applicant’s name]

whose photograph is attached and identified by my initials, attended my office, and has identified himself/herself by the production of his/her passport.

(b) that the originals of all certificates, diplomas, etc., have been produced to me; and that true copies accompany this certificate and are noted "Certified a true copy of the original”, which annotation is duly initialled by me.

Signature:

Description

of Office:

Date:

Name of

Authority:

Address:

Sign across corner

of photograph

AUTHORITIES RECOGNISED BY THE GENERAL OPTICAL COUNCIL

1.  AUSTRIA / Bundesministerium Für Wirtschaftliche Angelegenheiten, Abteilung 111/4, Stubenring 1, A-1010 Vienna, Austria
2.  BELGIUM / SPF Economie, Classes moyennes et Energie, Administration de la Politique PME, Division de la Riglementation
Monsieur J. FRERE, WTC III, Boulevard Simon Bolivar 30
26ihme itage, B -1000 BRUXELLES
Ph.: + 32-2-208.51.85 E-mail:
3.  Czech Republic / Ministry of Industry and Trade of the Czech Republic
Department of Trades, Politickych veznu 20
CZ - 110 15, PRAHA 1
Ms Milada HRABANKOVA, tel. +420-224 062 193
e-mail:
4.  DENMARK / The National Board of Health (Sundhedsstyrelsen)
Islands Brygge 67, P.O. Box 1881
DK-2300 København S, Denmark
Phone +45 72 22 74 00 Fax 72 22 74 11
Anne Lindrup E-mail:
5.  Estonia / Estonian Qualification Authority
Pärnu mnt. 142
11317 Tallinn,
Estonia
Tel: +372 679 17 00 Fax: +372 679 17 01
E-mail:
6.  Finland / National Authority for Medicolegal Affairs
P.O. Box 265, 00531 Helsinki
Tel. +358 9 772 920
7.  FRANCE / Ministère de la Santé, de la Famille et des Personnes Handicapēs
DHOS M1, Bureau de l'exercice médical
1, place Fontenoy, 75350 PARIS Cedex 07 SP

M Claude Bara Ph: 01 40 56 56 31

8.  GERMANY / ZVA Alexanderstrasse 25A
D-40210 Dusseldorf, Germany
0211 863 2350,
9.  GREECE / Ministry of Health and Prevention
Department of Health Professions
Aristotelous 17, T.K. 10187, Athens
+210 523 5875
10. Hungary / The ministry of Economy and Transport
H-1055 Budapest, Honvéd u. 13-15. Hungary
Tel.: +36-1-374-2700
11. IRELAND / Bord na Radharcmhastóirí (The Opticians Board)
18 Fitzwilliam Square, Dublin 2.
Tel: (01) 6767416, Fax: (01) 6621051, e-mail: .
Ms. Mary O'Donnell.
12. ITALY / FEDEROTTICA, Via Cenisio 32, Milano 20154, Italy

AIO, Via Giust 2, 50019 Sesto Fiorentino FI, Italy

13. Liechtenstein / Mrs. Dr. iur. Eva-Maria Hiebl,.
Schulamt des F|rstentums Liechtenstein
Europark / Austrasse 79
9490 Vaduz
F|rstentum Liechtenstein
Tel: 00423 / 236 73 30
14. LUXEMBOURG / M. A. Schroeder/M. J.P. Braquet
Ministere de l’Education Nationale et de la Formation Professionnelle
Rue Aldringen, 29, L-2926, Luxembourg
15. NETHERLANDS / NUVO, Postbox 677, 2003 RR Haarlem, The Nethelands
ALGEMENE NEDERLANDSE VERENIGING VAN OPTOMETRISTEN, Postbox 677, 2003 RR Haarlem, The Netherlands
16. NORWAY / NORGES OPTIKERFORBUND, Malmskriverveien 35 B, PO Box 419, N - 1301 Sandvika, Norway
17. Poland / Ministerstwo Zdrowia
Departament Nauki i Szkolnictwa Wyższego, ul. Miodowa 15
00-952 Warszawa
Mrs Goździk - tel. +48 22 634 9567, email:
Or Mrs Kister - tel. +48 22 634 9630, email:
18. PORTUGAL / UPOOP, Campo Grande 286-2dt, 1700 Lisboa, Portugal
APLO - Associação de Profissionais Licenciados de Optometria Portugal
www.aplo.pt
19. SPAIN / COLEGIO NACIONAL DE OPTICOS OPTOMETRISTAS, Princesa 25-1, Edificio Hexángono, 28008 Madrid, Spain
SOCIEDAD ESPANOLA DE OPTOMETRIA, Princesa 25-1, Edificio Hexangono, 28008 Madrid, Spain
20. SWEDEN / National Agency for Higher Education (Hogskoleverket),
Luntmakargatan 13
Box 7851, SE-103 99 Stockholm
Sweden
+46 8 563 08500 www.hsv.se