ASCRS Ophthalmology Hall of Fame Lounge Submission Form and Agreement
The American Society of Cataract and Refractive Surgery (ASCRS) has been proud to induct over 40 members into the ASCRS Ophthalmology Hall of Fame for their contributions to the science and practice of ophthalmology.
The ASCRS Ophthalmology Hall of Fame was created by ASCRS in 1999 to honor pioneers with an ongoing celebration of their distinguished career and contributions.
ASCRS is pleased to announce the opening of our newly redesigned ASCRS Ophthalmology Hall of Fame Lounge, which will have memorabilia on display at our upcoming 2017 ASCRS•ASOA Symposium & Congress, May 5–9, 2017 in Los Angeles, CA. You are invited to submit pertinent items for exhibit (either an actual item or photograph—see waiver agreement enclosed). In addition to items received by ASCRS Ophthalmology Hall of Fame honorees, we also plan to have photos of each honoree and biographical information.
We plan to have items on display each year at our Annual Symposium & Congress. In order to plan the size of this lounge at each Symposium, we ask that you complete the attached ASCRS Ophthalmology Hall of Fame Submission Form and return to our office. Due to certain restrictions, not all submissions can be selected for display. Your participation is encouraged. If you have any questions, please contact
Evelyn Morales at firstname.lastname@example.org or (703) 591-2220.
Please note the questions on the below submission form, especially those concerning insurance value and loan conditions.
Please complete ONE (1) form for each item you wish to submit for display—PLEASE TYPE.