Academy Volunteer Interest Survey

1. Welcome!

Thank you for your interest in volunteering for the American Academy of Optometry. This detailed survey, which takes an estimated 15 minutes, seeks to explore ways in which you would like to give your time to the Academy, as well as your particular strengths and skillset. This will help Academy leadership to best match your unique talents with the best possible volunteer opportunities.

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* Preliminary Information

Full Name

State/Province

Country

Email Address

Phone Number

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* Fellowship Year (skip if you're mid-process or beginning the process)

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* Demographics

American Indian or Alaskan Native

Asian or Pacific Islander

Black or African American

Hispanic or Latino

White/Caucasian

Prefer not to answer

Other (please specify)

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* Professional Work Setting (please check all that apply)

Private practice with optometrists only

Private practice with various health care professionals

Corporate practice (franchise or owned by corporation)

Health Maintenance Organization

Federal service (military, VA, Indian Health Service, etc.)

Academic (research, clinical, administrator)

Industry/Exhibitor

Retired

Resident

Student

Other (please specify)

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* Please list any previous service to the Academy within the volunteer structure

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* Please upload a copy of your CV.

PDF, DOC, DOCX file types only.

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