Honour a Mentor

Here is your opportunity to honour a mentor, while supporting the important work of the COS Foundation. Please use the form below to provide a short description of the impact that this individual has had on you, a photo of your mentor, and make a meaningful donation of $100, $250, or $500. Missing a photo of your mentor? No problem! The COS has an extensive collection of ophthalmologist profiles to help.

Together, let’s honour the mentors who make a difference in our lives and support the vital mission of the COS Foundation. Visit Our Mentors here.

Honour a Mentor Submission Form

"*" indicates required fields

Your Name*

First Last

Your Email*

Enter Email Confirm Email

Name of Mentor*

First Last

Explain the impact this individual has had on you:*

Consent to have your name listed on the page:*

Yes

You agree to have your name appear on Wall of Donors page in relation to the mentor you are honouring.

Photo of Your Mentor

Max. file size: 100 MB.

View Mentors Here