Skeffington Legacy Award 2024 Nomination Form

Skeffington Legacy Award 2024 Nomination Form
The Optometric Extension Program Foundation (OEPF) is proud to present the Skeffington
Legacy Award at the International Congress of Behavioral Optometry (ICBO). This award
recognizes individuals who have made exceptional contributions to the field of optometry,
particularly in behavioral optometry.
About the Award
The Skeffington Legacy Award honors the legacy of Dr. A.M. Skeffington, a pioneer in
behavioral optometry. We seek nominations for optometrists who exemplify Dr. Skeffington's dedication to:
- Advancing the field of vision therapy and behavioral optometry
- Promoting education and research in behavioral optometry
- Upholding the principles and practices established by Dr. Skeffington
Eligibility Criteria:
This award is open to all optometrists who have made significant contributions to the field.
Nomination Information:
Nominee Information:
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Nominator Information:
Name

First NameLast Name
Relationship to Nominee:
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Nomination Details:
Please describe the nominee's contributions to the field of optometry, particularly in behavioral optometry. Focus on the following areas:
Significant Contributions to OEPF and the Optometric Community: Describe the nominee's service to OEPF and the broader optometric community. Mention advancements made in understanding, education, and application of vision therapy and behavioral optometry.
Recognition of Service: Explain how the nominee embodies the principles and practices established by Dr. A.M. Skeffington. Highlight their dedication to upholding Dr.Skeffington's legacy.
Professional Involvement with OEPF (Optional): If applicable, detail the nominee's history of involvement with OEPF. This may include participation in educational programs, publications, or research projects that promote behavioral optometry.
Supporting Documentation (Optional):
You may upload additional documents to support your nomination, such as:
- Curriculum Vitae or resume of the nominee
- Letters of recommendation
- Articles or publications authored by the nominee
- Evidence of contributions to OEPF or the optometric community
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Deadline
All nominations must be submitted electronically by June 30, 2024.

Selection Process
A committee of OEPF Clinical Associates will review nominations based on the outlined criteria and nominations will be submitted to the OEPF Board for approval. The committee will select a recipient who best exemplifies the values of the Skeffington Legacy Award.

Award Presentation
The Skeffington Legacy Award will be presented at the ICBO on behalf of the OEPF. The recipient will receive a prestigious award and recognition in OEPF publications and media.

We encourage you to nominate a deserving optometrist who has made a lasting impact on the field of behavioral optometry!
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About the Award

Eligibility Criteria:

Nomination Information:

Nomination Details:

Supporting Documentation (Optional):