Ophthalmology Resident Application

  1. 1 Your information
  2. 2 Background
  3. 3 Documentation
  4. 4 Review


Name and position

Full name*

Examples: MD, MBA, PhD

Contact information


Example: 555-555-5555

Account login

Example: you@example.com Please use a permanent e-mail address that can be used for future communications beyond residency.
Must be 8 characters or more

By continuing with this application you confirm your intent to apply for membership in the ASRS as a Practicing Retina Specialist - Regular or International Member, Retina Fellow-in-Training (FIT) or International Fellow-in-Training (INT-FIT), or Resident Member.