Special Application on Merit for Specialty Certification

If you haven’t done so already, please review the Special Application on Merit Requirements.

Before uploading your files, please add your last name to the beginning of each one. For example, “yourlastname-cover-letter.pdf” and “yourlastname-cv.doc” will help speed up processing.

Date
Date Format: DD slash MM slash YYYY
First Name*
Last Name*
Middle Name
Your Email*
Application Files*
Drop files here or

Accepted file types: jpg, jpeg, png, gif, pdf, doc, docx, odt.
Please include a Cover Letter and CV documenting some or all of the following: National Recognition for Advanced Competence in Medical Optometry, Lectures, Workshops, Educational Meetings, Publications, Supervision of Residents, TMOD or ACMO Exams, Fellowship in the American Academy of Optometry, Fellowship in the Optometric Retina Society, Fellowship in the Optometric Glaucoma Society, Diplomate in the Ocular Disease Special Interest Group, Certification in Ophthalmology and/or Research in Medical Treatment of Ocular Disease.

--> Files accepted: jpg, jpeg, png, gif, pdf, doc, docx and odt

--> The RED X in a CIRCLE means you can DELETE a FILE
Attestation*
- I attest that the information submitted in this application is true and correct.
Authorization*
- I authorize ABCMO to make any inquires needed to verify the information provided above.
Special Application Fee*
Price: $300.00
Total
$0.00
Credit Card

Card Details

Cardholder Name