Optometric Glaucoma Society Meeting Registration

OPTOMETRIC GLAUCOMA SOCIETY
ANNUAL MEETING REGISTRATION
Anaheim, 2008

ALL FIELDS MUST BE FILLED IN OR REGISTRATION
CAN NOT BE COMPLETED

Name:
Address:
City:
State:
Zip:
Country:
Institution / Company:
Phone:
Fax:
Email:	For confirmation of registration
Tell us about your membership:	Check this box if you are an OGS member: Check this box if you are a GPS member: Check this box if you are a guest:
If you are a guest, which OGS member are you a guest of?
State and license # (if applicable):	Required for education credit.
Will you be attending the Business Meeting? (OGS Members only)	Check if yes 6:00pm, 20th October.
Will you be attending the Welcome Reception? (Open to all attendees)	Check if yes 7:00pm, 20th October.
Will you be attending the OGS meeting?	Check if yes 8:00am, 21st October.
Will you be attending the Honoree's banquet?	Check if yes 7:30pm, 21st October.
If you will be attending the Honoree's banquet...	check this box for Beef, check this box for Fish, or check this box for a Vegetarian dinner option. (choose only one)