Pennsylvania Academy of Ophthalmology
Pennsylvania's Eye Physicians and Surgeons

Application

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Individual Information


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Membership

Note: If you are applying for the Member-in-Training category, complete Training Verification Information section. Verification of the training program must be forwarded to our office. Forward a copy of your official letter of acceptance (begin and end dates must be included in the letter) to: PAO, 777 East Park Drive, Harrisburg, PA 17111. We will hold your membership application request until we receive the necessary documentation.



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NOTE: If selecting to pay by Check, please do not fill out the Credit Card Information section at the bottom of the form. Thanks.
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If paying by check, please mail check to PAO, 777 East Park Drive, P.O. Box 8820 Harrisburg, PA 17105-8820.

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Pennsylvania Academy of Ophthalmology.  All Rights Reserved.
777 East Park Drive  |  PO Box 8820  |  Harrisburg, PA 17105
Phone: (717) 558-7750 ext. 1518  |  Fax: (717) 558-7841  |  [email protected] 
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