Register |

Name *

First

Last

Entered EXACTLY as shown on your passport or travel-related government ID.

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone *

Email / Courriel *

Date of Birth *

Emergency Contact - name *

First

Last

Emergency Contact - phone *

University / Université *

Current PGY Year / Année postdoctorale actuelle *

I confirm I am available to attend the All About IOLs course in it’s entirety *

Yes / Oui
No / Non

Any food allergies or restrictions

Do you require air travel? *

Will you be staying at the hotel for the duration of the program? *

Yes / Oui
No / Non

If yes, what city would you be departing from?

Comments and Special Travel Requests

Travel will be booked according to the schedule of events. You must be in the hotel no later than 5:00PM on October 4th and not be able to book flights prior to 3:00PM on October 6th. Flights offered to you will be in accordance with these times.