Distinguished Service Award Nomination Form

Distinguished Service Award Nomination Form

DISTINGUISHED SERVICE AWARD

The Distinguished Service Award is given to an optometrist who has made an outstanding contribution over time to the achievement of the World Council of Optometry (WCO) Vision and Mission. This is the highest award that the WCO can bestow on an individual.

The selection panel will be chaired by the WCO President and will usually include two Past WCO Presidents. The Distinguished Service Award is usually presented at the General Delegates Meeting. This year, the award will be presented during the 2nd World Congress of Optometry in Hyderabad, India.

Nomination criteria

  1. There should be clear evidence of a real and important contribution over time to the achievement of the WCO’s Vision and Mission.
  2. Nominees must be a member of a WCO member organisation which is in good standing.
  3. Governing Board members are not eligible for this award until they have been off the Board for at least two years.
  4. Nominations are invited from members of the WCO and should include sufficient information to demonstrate how the criteria are met. This may include letters of recommendation, curriculum vitae and other relevant information.

Nomination deadline

Distinguished Service Award nomination forms should be sent to the WCO at enquiries@worldoptometry.org by June 30, 2017.

Find out more

The Distinguished Service Award nomination form can be found below.

DISTINGUISHED SERVICE AWARD

NOMINATION FORM

Nominator details

Name:                                                                                                                                  

Address:                                                                                                                              

Email:                                                                                                                                  

Organisation:                                                                                                                      

Nominee details

Name:                                                                                                                                  

Address:                                                                                                                              

Email:                                                                                                                                  

Organisation:                                                                                                                      

Please provide a brief statement below giving reasons for your nomination and forward any supporting documentation to enquiries@worldoptometry.org.

STATEMENT FOR NOMINATION

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