First registration step

General Information:
Fill out this form and click "next step". Note that fields with an asterisk (*) are mandatory.

You can enter two addresses,
the primary one being your mailing address.

Password: Must be a minimum of
6 characters.
We suggest you use something that will be easy for you to remember and difficult for others to guess.

Username: Must be a valid email address and can only be used by one person.
General Information:
Salutation:   Title:  
   
*First Name:   *Last Name:  
   
*Username:   *Password:  
   
Sex:   Birthdate:  
Male     Female    
 
         
*License #:   Province of Licensure:
 
Other License #   Province of Other Lic.
 
Please note that to become a member of this association
you must be licensed in this province.
     
*Address Type  
Company
 
*Address 1:   Address 2:
 
*Postal Code:   City:
 
*Province:   Country:
 
*Telephone:   Fax:
 
*Email:    
 

You can not have two work address.
Please verify the secondary address type.


To Find your company enter your postal code
Postal Code:
Address Type  
Company
 
Address 1:   Address 2:
 
Postal Code:   City:
 
Province:   Country:
 
Telephone:   Fax:
 
Email:    
 

You can not have two work address.
Please verify the primary address type.


To Find your company enter your postal code
Post Code:
Notes :
If you wish to purchase insurance through the Ontario Opticians Association, please click here.
Please select your insurance protection for the year 2012*.
  $81.00
  $97.20
 
*Dec 31st 2012


Questionnaire
Insurance cannot be issued unless the following questionnaire is received at the OOA office



I do not require insurance with the OOA.