NEW MEMBERSHIP APPLICATION 2020 - Australian ...

 
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NEW MEMBERSHIP APPLICATION 2020 - Australian ...
NEW
MEMBERSHIP
APPLICATION
2020
The Australian College of Optometry (ACO) is a         National Vision Research Institute
non-profit, member-based organisation dedicated        The National Vision Research Institute is dedicated
to improving public eye health.                        to researching the complexities of vision and its
Members join a collegial professional community        disorders and public health. Our vision is to achieve
helping to promote the importance of eye health to     world leading eye health care outcomes for all.
the public and health professionals, and also gain
access to a range of membership benefits.              Continuing Education
                                                       We provide best practice clinical learning pathways
What does the ACO do?                                  for optometrists from pre-registration through to
The ACO is dedicated to providing affordable public    professional practice.
eye care for people experiencing disadvantage.
                                                       Our Continuing Professional Development program
Victorian Eyecare Service                              offers flexible, innovative education for optometrists
We administer the Victorian Eyecare Service (VES)      across a broad range of clinical areas. We offer
and Victorian Aboriginal Spectacles Subsidy            over thirty CPD programs annually including clinical
Scheme (VASSS) in partnership with the State           workshops, seminars and webinars, refresher
Government of Victoria.                                courses, advanced certificates, and the ACO
                                                       National Conference.
Our services include primary eye care and extensive
                                                       Becoming a member of the ACO
outreach to people who are homeless, refugees
and asylum seekers, Aboriginal and Torres Strait       Registered optometrists are invited to apply for
Islanders, and supported residential services.         membership. Members are guided by, and agree to
                                                       adhere to, the ACO’s Code of Ethics and Conduct
Working with Aboriginal and Torres Strait Islander     Standards.
communities                                            Members of the wider community with a special
The ACO is proud to work with the Aboriginal           interest in optometry may apply for an Associate
and Torres Strait Islander health service sector,      Membership.
the Commonwealth Government, and community
                                                       First Year Graduates are offered a complimentary 12
members in reducing avoidable blindness in
                                                       month ACO membership with no voting rights.
Aboriginal and Torres Strait Islander communities.
We provide eye test equipment and training,            Optometry students are eligible for Student
comprehensive eye health consultations and visual      Membership which is free of charge. Please visit
aids, and referral pathways for primary care           aco.org.au to download the Student Membership
services.                                              application form.

                 AUSTR ALIAN COLLEGE OF OPTOMETRY NEW MEMBERSHIP APPLICATION –– 1 OF 4 ––
NEW MEMBERSHIP APPLICATION 2020 - Australian ...
Voting Members
                                                            2020 Fees
Classes                           2020 Fees AUS                                                        Class Definition
                                                               NZ
                                                                                An optometrist who is registered to practise in Australia
Member                                $355.00                 $322.73
                                                                                or New Zealand
                                                                                Registered optometrist eligible for ACO membership
Member working less
                                      $265.00                 $240.41           but currently working less than 10 hours per week (25%
than10 hours per week
                                                                                discount)
                                                                                Registered optometrist eligible for full ACO membership
Non-practising
                                      $180.00                 $163.64           but currently non-practising due to illness or retired, taking
optometrist
                                                                                parental or study leave (50% discount)
                                                                                Resides outside Australia or New Zealand, holds an
Affiliate                             $180.00                 $163.64           overseas qualification in optometry and is not currently
                                                                                registered to practise in Australia or New Zealand
Associate                             $60.00                   $54.55           Those with a special interest in optometry or an allied field
                                                                                Those with a special interest in optometry or an allied
Associate (CPD)                       $180.00                 $163.64           field who also want to access continuous professional
                                                                                development.

Non Voting Members
Classes                                Class Description
First Year Graduates*                  Free one-year membership granted to graduates within 12 months of graduating from an
                                       Australian or New Zealand optometry school.
Student*                               Free membership for students at Australian or New Zealand optometry schools invited to
                                       join the College. No access to CPD points.
Note: all fees include GST. Where a member resides overseas GST is not applicable.
*Student Members and First Year Graduates do not hold voting rights

Membership Benefits
Membership will entitle you to:
• A comprehensive range of education programs (including courses, clinical workshops, CPR courses, webinars, the
  ACO National Conference and the Advanced Certificate courses) at substantially reduced rates.
• Free access to 2019 and 2020 ACO Seminar Series lectures. All lectures are accompanied with optional assessments
  (20 CPD points per year available, additional points for attending in person).
• Complimentary annual CPD points statement provided.
• Services and resources from the Nathan Library, including online access to the Australian Medicines Handbook and
  access to journal articles from Optometry and Vision Science.
• The opportunity to apply for ACO Travel Grants (following 12 months’ membership). For more information on
  eligibility criteria please visit our website aco.org.au.
• The opportunity to apply for Fellowship of the ACO following three years of continuous membership. Fellows are
  recognised as having significantly contributed to the practice and profession of optometry and to the community.
• Free inFocus newsletters and regular ACO eNews.
• The opportunity to participate in ACO advisory groups and be nominated to serve on the ACO Council (not
  applicable to First Year Graduates or Student Members).
• Voting rights at the ACO Annual General Meeting.

                         AUSTR ALIAN COLLEGE OF OPTOMETRY NEW MEMBERSHIP APPLICATION –– 2 OF 4 ––
NEW MEMBERSHIP APPLICATION 2020 - Australian ...
ACO Membership Application Form

TITLE (please circle):   MR       MRS      MISS      MS      DR   PROF      OTHER (please specify):

GIVEN NAMES:		                                 PREFERRED NAME (if different):

FAMILY NAME:

DATE OF BIRTH:                |         |		                             OA/ODOB NUMBER:

QUALIFICATIONS:		                             INSTITUTE:			                                           YEAR:

QUALIFICATIONS:		                             INSTITUTE:			                                           YEAR:

POSTAL ADDRESS:

TOWN/CIT Y:		                                 STATE:                    POSTCODE:          COUNTRY:

TELEPHONE: (             )		                  MOBILE TELEPHONE:

EMAIL ADDRESS:

I AM REGISTERED TO PR AC TICE OP TOME TRY IN AUSTR ALIA OR NE W ZE AL AND                       YES        NO

I AM CURRENTLY PR ACTISING AT:

STREET ADDRESS:

TOWN/CIT Y:		                                 STATE:                    POSTCODE:          COUNTRY:

BUSINESS TELEPHONE: (              )                       BUSINESS EMAIL:

my preferred postal address is:         residential (as above)     business (as above)

my preferred email address is:          residential (as above)     business (as above)

i agree to have my name published in aco publications:            yes      no

I consent to the ACO collecting, storing and using my personal information for the purpose of administering my
membership and providing ACO related services to me (unless I have “opted out” by contacting the Membership
Division).
As a member of the ACO I agree to practise in accordance with the ACO Code of Ethics and Conduct Standards and
to be bound by the current provisions of the ACO’s Constitution.
In signing this document I confirm I have read and comply with the ACO Code of Ethics and Conduct Standards as
listed on the ACO website at aco.org.au/membership.
If you have any questions regarding the Code of Ethics or Conduct Standards, please contact the Membership
Division Phone: (03) 9349 7578 Email: membership@aco.org.au.

   I declare that all the information supplied on this application is accurate.

SIGNATURE				                                                                               DATE       |         |

                    AUSTR ALIAN COLLEGE OF OPTOMETRY NEW MEMBERSHIP APPLICATION –– 3 OF 4 ––
NEW MEMBERSHIP APPLICATION 2020 - Australian ...
ACO Membership Application Form
I wish to apply to join the Australian College of Optometry in the following class:

                                    AUS             NZ

   Member                                                  An optometrist who is registered to practise in Australia or
                               $355 .00        $322.73
                                                           New Zealand
    ember working
   M
   less than                                               Registered optometrist eligible for aco membership but
                               $265 .00        $240.41
   10 hours per week                                       currently working less than 10 hours per week (25% discount)

    on-Practising
   N                                                       Registered optometrist eligible for full aco membership but
   Optometrist                  $180 .00       $163.64     currently non-practising due to illness or retired, taking
                                                           parental or study leave (50% discount)
                                                           Resides outside australia or New Zealand, holds an overseas
   Affiliate                    $180 .00       $163.64     qualification in optometry and is not currently registered to
                                                           practise in australia or New Zealand
   Associate                     $60 .00        $54.55     Those with a special interest in optometry or an allied field

   A s s o c i a t e (C P D)                               Those with a special interest in optometry or an allied field
                                $180.00         $163.64
                                                           who also want to access continuous professional development
                                                           New graduates within 12 months of qualifying from an
  1st Year                                                 australian or New Zealand optometry school. Maximum
Graduate*                          FREE            FREE    period of membership at this level is 12 months of the
                                                           calendar year immediately following their graduating year.
                                                           *Non-voting member

Optional Services: Please indicate if you would like to purchase the following service

   CO Webinar Package $150: Live access to all 2020 webinars and access to 2019 webinars online. All
  A
  webinars are accompanied by online assessments (20+ CPD points)

Areas of interest
  Cornea & Contact Lens             Glaucoma       Low Vision     Ocular Disease
  Ocular Therapeutics           Paediatric Optometry      Vision Science      Other (please specify)

Donation
I would like to make a donation to the ACO for use in the following area:
                                                                                  Amount $
  Research                 Eye care for disadvantaged           General

Pay by email		                 Complete this form and email to membership@aco.org.au
Pay by mail 		                  omplete this form and pay by credit card or cheque (made payable to the Australian College
                               C
                               of Optometry). Mail to the Membership Division, Australian College of Optometry, 374
                               Cardigan Street, Carlton, Victoria 3053

I enclose payment of ...       TOTAL $
    Cheque        payable to: australian college of optometry
    debit the following credit card with my PAYMENT TOTAL                  visa          mastercard

card number                                                                       CVV                  expiry

NA ME ON C ARD		                                   SIGNATURE		                                     DATE     |   |

For more information contact the Membership Division (03) 9349 7578 | membership@aco.org.au | aco.org.au

                       AUSTR ALIAN COLLEGE OF OPTOMETRY NEW MEMBERSHIP APPLICATION –– 4 OF 4 ––
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