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Fellow Nomination Forms

OSA bylaws specify that: "Any regular member who has served with distinction in the advancement of optics is eligible for transfer to the class of fellow."

You must be a Fellow to nominate a regular OSA member to the rank of Fellow. To nominate, complete this Fellow Nomination Form and arrange for three to five individuals (at least one of whom must also be an OSA Fellow) to complete a Fellow Reference Form.

You may use the online form, download and mail the form below, or email awards@osa.org for Word files of the forms or printed copies.

Nominations are reviewed by the Fellow Members Committee each summer. Their report must be approved by the Board of Directors. Elected Fellows are notified in November following the deadline. Fellows shall pay the same dues as regular members.

PDF Fellow Nomination

Fellow Nomination Form (

PDF, 14 KB)

Note: You need Adobe Acrobat to view the PDF files above. If you do not already have this software, you can download Adobe Acrobat for free from Adobe's web site.

Online Fellow Nomination

Please be aware that your session will time out after 90 minutes and plan accordingly. Unfortunately, your entry will not be saved unless you submit it within 90 minutes.

*Indicates Required field

* Select one (1) of the OSA Technical Divisions which most closely fits the work of the nominee. See http://www.osa.org/join/techgroups/ for more information on the Divisions.

*Technical Divisions:
Your Information
*First Name:
*Last Name:
*OSA Member No.:
Company/Institution:
Department/Mailstop:
*Street Address:
*City:
*State/Province:
*Country:
*Postal Code:
Phone:
Fax:
*E-mail Address:

Fellow Nominee Information

*First Name:
*Last Name:
*Affiliation/Position:
Gender:	(Optional - data collected for statistical purposes only.)
*Citation:	Please summarize the nominee's contribution in 20-30 words. The citation will be based on your summary.

Additional Information

Please prepare a document that provides the following information on the nominee. The total material submitted by the nominator may not exceed 10 pages in length, single-sided, in legible type.

Academic record and honors —honors, field of study, dates attended, degrees awarded
Areas of professional specialization—list specific optical science and / or engineering professional accomplishments and contributions meriting election to fellowship
Other noteworthy accomplishments in science, engineering, and public service—service to OSA, boards, committees, consultantships (include dates)
Principal professional society memberships and activities—indicate membership grade, contributions to the work of the society, important offices held, and committee activities
Employment history—list employer, position, and dates
Publications and patents—list significant work, publications, and patents to support this nomination

Click on the Browse button and navigate to find the file on your computer. Double click on your file to put the path and filename in the box. Press the Submit button to continue. Note: we accept the following file extenstions: .doc, .txt, .pdf, .zip.

References

List the individuals who have already agreed to complete a Fellow Reference Form for the candidate. A minimum of three references is required; no more than five will be accepted. One of the referees must be an OSA fellow. References from different institutions are preferred.

*First Reference's Name:
*Affiliation:
Phone:
*E-mail:

*Second Reference's Name:
*Affiliation:
Phone:
*E-mail:

Third Reference's Name:
Affiliation:
Phone:
E-mail:

Fourth Reference's Name:
Affiliation:
Phone:
E-mail:

Fifth Reference's Name:
Affiliation:
Phone:
E-mail:

Your on-line submission will be acknowledged by an e-mail message. If that message does not appear within a reasonable period, please contact awards@osa.org to confirm that your nomination was received.