This form is for Registration in the Optometry Examining Board's Volunteer Program

Important! Please ensure that all information you have entered is correct.
If you have already registered as a volunteer, please Login Here

Privacy & Your Personal Information
OEBC’s role is to assess competence in the practice of optometry in Canada. For examination staff and volunteers, the primary purpose of collecting and maintaining personal information is to ensure appropriate resources, including professional representativeness and diversity, to conduct assessments and to communicate appropriately with them. These individuals may receive communications from OEBC through email, postal mail or fax. Examples of personal information we collect for this purpose includes name, email address, mailing address, phone number, education as well as professional information. OEBC recognizes the importance of privacy of personal information. OEBC is committed to collecting only the information that it needs and protecting any personal information that it holds.
 

For inital registration and graduation dates, please estimate the month and year if you do not remember.

1. Your Name

2. Contact Information

Home Address

Practice Address

3. Interests

I'm Interested In:

4. Education

5. Registration. I am currently registered in the following provinces:

6. Declaration of Professional Involvement

If you answer “yes” to any of the following questions (6.3 - 6.10), please provide details in the space provided at the end of the form

If you answered “Yes” to questions 6.3 – 6.10, please use the space here to further explain. If you answered "No" please write N/A or Not Applicable in the field below.