Glaucoma Fellows Course & Wet Lab 2021

Registration Options

Current Glaucoma Fellow

Name

Degree

Mobile Number

Institution Name/Affiliation

Country

Work Address

City, State and ZIP Code

What is your fellowship program name?

What is your program director's name?

How did you hear about this activity?

Will you be attending the Glaucoma Symposium on Saturday, October 9th?

Do you need a hotel reservation?

Provide Check In Date

Provide Check Out Date

I confirm I am a current glaucoma fellows.*

Please note: Due to an overwhelming demand to attend this event, limited space is available. Your application will be reviewed and you be notified within 8 days of your application if your registration is confirmed. You must be a current glaucoma fellows to participate in this course.

Please keep me posted on future activities.

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