* = Required
Ophthalmologist Name*
Degree*
Practice Name*
Email*
Confirm Email*
Address*
City*
State*
Zip Code*
Phone*
Fax
Website
 

Practice Emphasis:* Select TWO based on Specialties Listed on National AAO Website
Administration/Business
Anterior Segment
Cataract/Intraocular Lens (IOL)
Comprehensive Ophthalmology
Conjunctivitis/Lids
Contact Lenses
Cornea/External Disease
Glaucoma
Low Vision/Rehabilitation
Medial Retina
Neuro-Ophthalmology
Ocular Oncology
Ophthalmic Pathology
Ophthalmic Surgery
Optics Refraction
Pediatric Ophthalmology
Plastic/Reconstructive
Public Health
Refractive Surgery
Retina/Vitreous Surgery
Strabismus
Trauma
Uveitis/Immunology
 

***All NJAO members will be listed on the NJAO website unless indicated below.***

YES. Publish my information on the NJAO website.
NO. I DO NOT want my name/office listed on the NJAO website.
 

2012 Membership Dues
Regular Member - $550
      ($600 as of Feb 17, 2012 // $650 as of July 1, 2012)
First Year In Practice Member - $450
      ($500 as of Feb 17, 2012 // $550 as of July 1, 2012)
Senior Active Member - $400
      A Senior Active Member is a physician who has been an Active Member
      for at least 20 years but now has a limited practice.
Residents and Fellows - $0
      Residents and Fellows pay no dues while they participate in
      an accredited residency or fellowship program.
As in the past, contributions or gifts to the New Jersey Academy of Ophthalmology (NJAO) are not tax deductible as charitable contributions for income tax purposes. They may be tax deductible as ordinary and necessary business expenses, however, as a result of the federal budget and tax laws passed in 1993, any portion of dues used for lobbying activities are no longer tax deductible for federal purposes. Based on the portion of dues allocated for lobbying, NJAO estimates that the non-deductible portion of your 2012 dues to NJAO is 50 percent.
THANK YOU FOR YOUR CONTINUED SUPPORT.

Or click here to download/print/and mail your renewal form with payment.