PAAO - Pan-American Association of Ophthalmology

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Membership Categories and Dues Amounts (US $) Click on the button below to pay your membership dues.
Active Member (Miembro Titular): A physician who holds a degree of Doctor of Medicine, Doctor of Osteopathy, or equivalent medical degree as determined by the Board of Directors, who holds a valid and unrestricted license to practice medicine in the country in which the practice of medicine is regularly conducted, who has completed formal training in ophthalmology or its equivalent, as determined by the Board of Directors, and who is a member in good standing of the national society affiliated with the Association in the country in which the practice of medicine is regularly conducted in all countries with an affiliated national society (Canada, USA, Central America, South America, Caribbean). Annual dues are US$150.
Corresponding Member: A physician who holds a degree of Doctor of Medicine, Doctor of Osteopathy, or equivalent medical degree as determined by the Board of Directors, who holds a valid and unrestricted license to practice medicine and is a member in good standing of the national ophthalmological society in a country outside the Western Hemisphere in which the practice of medicine is regularly conducted, who limits the practice of medicine to ophthalmology or a related field, and who has a total period of ophthalmology training and practice of at least three (3) years, shall be eligible to apply for membership as a Corresponding Member (Europe, Africa, Asia, Australia). Annual dues are US$100.
Member-in-Training: A physician who holds a degree of Doctor of Medicine, Doctor of Osteopathy, or equivalent medical degree as determined by the Board of Directors, and who is engaged on a full-time basis in an ophthalmology training program in the Western Hemisphere that is acceptable to the Board of Directors shall be eligible for membership as a Member-in-Training for a period of up to five (5) years. Maximum age 35. Annual dues are: 1st year ..... dues waived 2nd year ..... US$25 3rd, 4th and 5th year ..... US$50/year
Affiliate Member: A person who holds a degree of Doctor of Medicine, Doctor of Osteopathy, or Doctor of Veterinary Medicine, or Doctor of Philosophy, and who is not an ophthalmologist but is engaged in a field allied with or in a basic science related to ophthalmology, shall be eligible to apply for membership as an Affiliate Member. Annual dues are US$75.

Membership Category (select one)			Annual Dues
Dues - Active Member/Miembro Titular			$150.00
Dues - Corresponding Member			$100.00
Dues - Member-in-Training (2nd year)			$25.00
Dues - Member-in-Training (3rd, 4th, 5th year)			$50.00
Dues - Affiliate Member			$75.00
Dues are based on a calendar year. Payment must be made in United States currency. Accepted forms of payment include cash, check, International MasterCard or Visa, American Express, and wire transfers. * A letter confirming your enrollment/participation in a full-time training program MUST be forwarded to the PAAO Administrative Office by fax (817-275-3961) or email (info@paao.org)
Please include ALL information: Full Name: Please write your Last Name/Surname in CAPITAL letters (ie John Michael SMITH MD, Maria GONZALEZ SANCHEZ)
First Name(s):
Middle Name(s):
Last Name(s):
Suffix(es): Degree(s):
Mailing Address:
City: State:
Zip Code: Country:
Telephone: Fax:
Email: Email is the PAAOs primary method of communication with its members. As a member, you will receive notices on upcoming meetings, events, educational programs, scholarships, and other related activities. The PAAO will protect your email address from inappropriate use.
Date of Birth (mm/dd/yyyy):
Languages:
Ophthalmology Residency Training Program (include year completed):
Fellowship Training Program(s) (include training dates):
Subspecialty Interest(s) (ie glaucoma, cataract, etc):
Certification: Please list the countries in which you are licensed to practice medicine:
If you would like to download the membership application form and send it by fax or email, please use one of the following forms:
DOC form:English	Formulario DOC: Español	Ficha DOC: Português
PDF form: English	Formulario PDF: Español	Ficha PDF: Português

BY CLICKING THE 'ADD TO CART' BUTTON AND SUBMITTING THIS APPLICATION, I AGREE THAT I HAVE READ AND FULLY UNDERSTOOD IT, AND I AGREE THAT EACH OF THE FOLLOWING STATEMENTS ARE TRUE: All information submitted on or in support of this application is true, accurate, and complete. I understand and agree that all such information is subject to review and verification by or under the supervision of the Board of Directors of the Pan-American Association of Ophthalmology ("PAAO"). I authorize and consent to that review and verification and all inquiries and good faith disclosures about me that may be made in the course of that verification process. I authorize all persons who have information about me to report such information to the PAAO. I hereby waive and release, indemnify, and hold harmless the PAAO and its Members, Directors, officers, employees, and representatives, the endorsers of this application, and all other persons and entities, or any of them, seeking, obtaining, providing, disclosing or acting upon any such information about me, from, against, and with respect to any and all claims, losses, costs, expenses, damages, liabilities, and judgements of any kind arising, or alleged to have arisen, out of, with respect to, or in any connection with seeking, obtaining, providing, disclosing, or acting upon any such information. I agree to comply with the PAAO's Code of Ethics as a condition of initial and continued membership in the PAAO. I understand and agree that my continued status as a Member will be subject to all of the terms and conditions of the Bylaws of the PAAO, and that the Board of Directors of the PAAO may revoke my membership if this application contains or is supported by information that omits or contains a substantial misstatement of any fact required or permitted by this application or the related instructions to be included on or submitted with or in support of this application. The Pan-American Association of Ophthalmology does not discriminate in membership as to race, national origin, religion, creed, gender or sexual preference.

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