FREE NYS Continuing Education Credits in NYC State Continuing Education Sponsor ID# 042004-042007.001 NYSSO Brings 2 August CE Events to New York City Come for the latest Society news & quality professional development! Renew your NYSSO membership or join the Society and receive your credits for FREE!

NYSSO Manhattan Meeting at TCI College of Technology Tuesday, August 2, 2011 6:30 - 9:30 pm (3 Credits Offered) All attendees entered for 6:00 pm ...... Sign In/Registration Begins Prize Drawings! (Refreshments & Snacks compliments of Luzerne Optical)

6:30 pm ...... NYSSO Updates with Vice President Ethan J. Brown & State Office Staff

6:30 – 8:30 pm ...... The Freeform & Digital Technology Revolution and What It Means to Your Office with Ralph Kent, ABOC, Terr. Sales Manager, Luzerne Optical (Two (2) NYS Ophthalmic Dispensing Credits) Compliments of Luzerne Optical Laboratories

8:30 – 9:30 pm ...... The Not So Ordinary Soft Contact : Current and Future Specialty Designs with Susan A. Resnick, OD, FAAO, Diplomate CCLRT, AAO (One (1) NYS Dual /Ophthalmic Dispensing Credit) Compliments of Alden Optical

Special Thanks to Our Meeting Underwriters Meeting Location TCI College of Technology Ophthalmic Dispensing 320 West 31st Street Program Chair (between 8th & 9th Avenues) Jayne Weinberger New York, NY 10001 & TCI Staff

NYSSO Metro Summer Regional Symposium at LaGuardia Sunday, August 14, 2011 9:00 am - 1:00 pm (4 Credits Offered) All attendees entered for 8:15 am...... Sign In/Registration Begins Prize Drawings!

9:00 - 10:00 am ...... Reading Our Patients Signs: The Benefits of No-Glare with Greg Rodriguez, ABOC (One (1) NYS Ophthalmic Dispensing Credit) Compliments of Essilor of America

10:00 – 11:00 am...... Advanced PAL Design: Progressive Design in the Digital Age with Greg Rodriguez, ABOC (One (1) NYS Ophthalmic Dispensing Credit) Compliments of Essilor of America

11:00 am – 1:00 pm...... The Freeform & Digital Technology Revolution and What It Means to Your Office with Ralph Kent, ABOC, Terr. Sales Manager, Luzerne Optical (Two (2) NYS Ophthalmic Dispensing Credits) Compliments of Luzerne Optical Laboratories

Special Thanks to Our Symposium Underwriters Symposium Location Courtyard by Marriott LaGuardia 90-10 Grand Central Parkway East Elmhurst, NY 11369

NYSSO's Membership Year Begins September 1st...Renew at these NYC Events! For more information: (518) 426-0599 You'll receive the CE Credits for FREE and your membership will go until next August 31, 2012! www.nysso.org New York State Society of Opticians 1450 Western Avenue, Suite 101 Albany, New York 12203

NYSSO Bringsto New 2 AugustYork City... CE Events FREE! Renew/Join & Get Credits for

Membership Application

INDIVIDUAL’S NAME ______COMPANY______HOME ADDRESS ______FAX # ______BUSINESS ADDRESS ______EMAIL ADDRESS ______PHONE (HOME) ______PHONE (BUSINESS) ______Preferred Address: ❑ Home ❑ Business Preferred Phone: ❑ Home ❑ Business

Membership Type: ❑ Active ($150.00/185.00) ❑ Newly Licensed-Active (See below/$150.00) (See below for category descriptions) ❑ Associate ($100.00) ❑ Corporate ($185.00) ❑ Student (Dues Waived)

Method of Payment: ❑ Check (payable to NYSSO) ❑ Credit Card (please complete section below)

Type of Credit Card: ❑ American Express ❑ Discover ❑ Mastercard ❑ Visa Dollar Amount:______

Expiration Date: ______Card #: ______Signature: ______

Voluntary Opticians PAC Contribution (Contributions to the NYSSO Political Action Committee) ❑ $25.00 ❑ $50.00 ❑ $75.00 ❑ $100.00 ❑ Other ______

Membership Year is September 1-August 31. Mail Application to: NYSSO, 1450 Western Avenue, Suite 101, Albany, NY 12203. NYSSO State Office (518) 426-0599 E-mail: [email protected] • Web Page: www.nysso.org

To be listed accurately in the NYSSO Please Complete the Following: Membership Directory, please indicate Region (see map) ______Date of Birth: ____/____/____ which of the following services are offered ❑ ❑ by your business: NYS License # ______Sex: Male Female ❑ Artificial Eyes ❑ Contact Lenses Contact Lens Fitter # ______Signature______❑ Eyeglasses ❑ Refractions Available ❑ ❑ Hearing Aids Low Vision Sponsor (if applicable): ______Date______

Region 1 -- Niagara, Erie, Chautauqua, Cattaraugus Region 2 -- Orleans, Monroe, Wayne, Genesee, Wyoming, Please indicate to which organizations you belong: Livingston, , Yates, Seneca, Schuyler, Chemung, Steuben, Allegany ❑ American Board of Opticianry Certified (ABO) Region 3 -- St. Lawrence, Jefferson, Lewis, Oswego, Oneida, ❑ 4 Herkimer, Cayuga, Onondaga, Madison, Otsego, Chenango, Cortland, Fellow, National Academy of Opticianry (FNAO) 1 2 3 Tompkins, Tioga, Broome, Delaware ❑ Region 4 -- Clinton, Franklin, Essex, Hamilton, Warren, Saratoga, Opticians Association of America (OAA) , Fulton, Montgomery, Schenectady, Schoharie, Albany, ❑ National Contact Lens Examiners (NCLE) Rensselaer, Columbia, Greene, Ulster, Sullivan, Dutchess 5 Region 5 -- Bronx, New York, Queens, Kings, Richmond, Orange, ❑ 7 Putnam, Rockland, Westchester Contact Lens Society of America (CLSA) 6 Region 6 -- Nassau Region 7 -- Suffolk Membership Categories ACTIVE MEMBERSHIP — Annual dues of $150.00 (by 9/30/11); $185.00 after that CORPORATE MEMBERSHIP — Annual dues of $185.00. Any proprietor- date. Any person possessing a valid New York State Ophthalmic Dispensing License is ship or corporation maintaining 51% of its licensed opticians as members of this eligible to become an Active Member. Society and upholding the by-Laws and constitution of the Society is eligible to become a Corporate Member. Corporate Members are entitled to all rights of an NEWLY LICENSED MEMBERSHIP — Upon obtaining a NYS License, the Active Member, except voting and may participate in all activities of the Society, optician will receive a complimentary year of membership. the following year, the unless specifically excluded by the Board of Directors. optician will be invoiced for the rate of $150.00. Newly licensed opticians who join under the special offer will be entitled to full Active Member benefits. STUDENT MEMBERSHIP — Annual dues waived. Any person who is enrolled as a student in a New York State-accredited program for Ophthalmic ASSOCIATE MEMBERSHIP — Annual dues of $100.00. Any person who does not Dispensing is eligible to become a Student Member. Student Members are entitled qualify for Active membership but is supportive of opticianry shall be eligible to become to all rights of an Active Member, except voting and may participate in all activities an Associate Member. Associate Members are entitled to all the rights of an Active of this Society, unless specifically excluded by the Board of Directors. Member, except voting and may participate in all activities of this Society, unless specifically excluded by the Board of Directors. Metro Events 8/11