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In applying for membership in the Mississippi Association of Dispensing Opticians, I understand that approval of membership is at the discretion of the present Board of Directors, and if approved I have the duty to abide by all present and future rules and bylaw provisions of the association. Dues are currently $85 per year.


Reasons to join MADO
 

 

Strength in Numbers

Certification

Education

National Affiliation

Information Services

Referrals

Web Development Services

More...


 

 
* Required fields  
Personal Info: Company Info:
Title:*   Company:*  
First Name:*   Address:*  
Last Name:*   City:*  
Address:*   State:*  
City:*   Zip:*  
State:*   Phone:*  
Zip:*   Fax:*  
Phone:*   E-mail:*  

Is the firm where you work a branch office?
*
  Yes No    
If Yes, please give name and address of main office and title of a representative:
Company:*  

Contact Name: 

Address:*      
City:*      
State:*  
Zip:*  
If your firm is a partnership or corporation, give name, city, and state of partner(s) or
Board of Directors and/or major stockholders?
*
Name:*  

City:*  

State:*  
 
Name:*  

City:*  

State:*  
 
Name:*  

City:*  

State:*  

In what capacity are you employed?
*
Sole Proprietor    Partner 
Employee Office Manager
Other:*  

Is the firm engaged in wholesale distribution only?
*
Yes No
How long have you been a dispensing optician? *
0-5 yrs    
5-10 yrs
Over 10 yrs
Indicate certifications held: 
  Chartered Certified ABO Optician
Yes    No  
Certificate #
 Certified ABO Optician
Yes     No
Certificate #
Yes     No
Certified NCLE Optician
Certificate #
Other
Certification
Certificate #

Give a brief resume of your education, training, and experience:
*


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