HOME 

OPHTHALMIC SUPPORT STAFF REGISTRATION FORM

Registrant Information


Email Address*

Name* (lastname, firstname middleinitial suffix)

Street Address*

City

Province*

Zip Code*

Tel. No.(Country Code + Area Code) + Number*

Fax. No.(Country Code + Area Code) + Number


Registration Fee

COURSES CODE ADVANCED RATE
(Until November 15, 2019)
ONSITE RATE
(Starting November 16, 2019)
December 05, 2019 (Thursday)
Basic Course* BC PhP 2, 000.00 PhP 3, 500.00
December 06, 2019 (Friday)
Cataract Surgery Course** CS PhP 1, 750.00 PhP 2, 500.00
Oculoplasty Course/
Pediatric Ophthalmology and Strabismus Course**
OPL/PEDS PhP 1, 750.00 PhP 2, 500.00
Error of Refraction/
Refractive Surgery Course**
ER/RC PhP 1, 750.00 PhP 2, 500.00
Glaucoma Course** GC PhP 1, 500.00 PhP 2, 200.00
Retina Course** RC PhP 2, 200.00 PhP 3, 000.00
Note:
*Fee is inclusive of handouts, materials and lunch.
**Fee in inclusive of handouts and materials ONLY
Pre-registered participants are reserved handouts.
For on-site registrants, hand-outs will be given on a "first-come first-served" basis, until supplies last.
  • Fill-Out Form
  • Payment Verification
  • Payment Confirmation