Newly Hired VA Optometrists Member Form

This form is for NEWLY Hired VA Optometrists only.
NAVAO is recognized as a 501(c)6 organization by the Internal Revenue Service and it is a not-for-profit organization. Any VA staff, attending, or consultant optometrist, or any other optometrist having an interest in VA optometry shall be eligible for membership in the NAVAO.

Last Name	*
First Name	*
Facility	*
Address1	*
Address2
City	*
State	*
Zipcode	*
Phone	*
Fax
Your va.gov Email	*
Hired Date	*

According to Article I, Section I of the NAVAO By-Laws: "All newly hired VA optometrists will be provided free membership in the Association for the calendar year in which their employment at the VA commenced."