The Optical Society - SeniorMemberReference

OSA Senior Member Reference Form

*Important: You will receive a confirmation email upon submitting a Senior Member endorsement statement. If you do not receive an email, please contact: seniormember@osa.org

If you have been asked to complete a Senior Member Reference Form, you may use the online reference form below.

Please note: You must have an active OSA membership in order to serve as a reference. If you are not yet an OSA member, you can enroll online.

Senior Membership provides well-established individuals with the opportunity to request a designation that recognizes their experience and professional accomplishments and/or service within their field.

OSA Senior Member requests are reviewed once a year. The next round of Senior Member applications will be reviewed May 2013. Complete applications are due no later than 28 February 2013.


Senior Member Candidate Name:
Your Information
Your OSA Member #: (if known):
First Name:
Last Name:
Email:
Reference
Endorsement Statement - In 4000 words or less, please provide two or more examples of the candidate's key professional achievements. Note: If you prefer to send a separate document, please do so using the contact information below:
Captcha:

Optional: If you would like to send additional reference materials about the candidate, please submit them electronically or by mail.

Email:	SeniorMember@osa.org
Fax:	+1.202.416.6130
Mail:	OSA Membership Department 2010 Massachusetts Ave NW Washington, DC 20036 USA

OSA

Advancing the Science and Technology of Light

SeniorMemberReference

Forms

OSA Senior Member Reference Form

Your Information

Reference