2013 Meeting Registration

Group Registration -    DOWNLOAD FORM
CONTACT INFORMATION
*First/Given Name: *Last/Family Name:
*Degree:
*Address:
*City:
*State/Province:
*Zip/Postal Code:
*Country:
*Phone:
Fax:
*E-mail:
Year of Birth:
Year of Medical
School Graduation:
State of Practice:

 
*How did you hear about the meeting?
(Multiple selections allowed) 		Ocular Surgery News Print Advertisement
OSN SuperSite and/or News Wire
OSN Exhibit Booth
E-mail
Letter
Brochure
Flyer
Phone
Word of Mouth
Internet Search
Other
Priority Code
Please enter the priority code found on the lower right-hand corner of your brochure
registration form (inside back cover) or other marketing materials.
Codes contain 3 numbers, a dash, and then more number(s).

*REGISTRATION TYPE

Comprehensive Ophthalmologist Program

This program offers AMA PRA Category 1 Credits™. Comprehensive Ophthalmologist registration is valid for physicians only. Registration includes admission to general program sessions, workshops, seminars, the exhibit hall and special events.
A. Physician: Register early and save $155! .......... US $1195 + 4.16% Hawaii Excise Tax = $1244.71
AA. Physician: Standard registration .......... US $1350 + 4.16% Hawaii Excise Tax = $1406.16
ARF. Resident/Student (Please submit letter of verification) .......... US $690 + 4.16% Hawaii Excise Tax = $718.70
Primary Subspecialty (please check one):
Cataract surgery
Contact lenses
Cornea/External disease
General ophthalmology
Glaucoma
Retina* 		Neurosciences
Oculoplastics
Optics
Pediatrics/Strabismus
Refractive surgery
* If you are registering for Retina 2013, click here.
CME Activity Request
Yes, I would like the opportunity to earn CME credits through future activities
jointly sponsored by Ocular Surgery News and Vindico Medical Education.

Nurse/Allied Health Program

This program offers CNE and JCAHPO credits. All nurse/allied health professionals must be actively employed in a medical practice. Registration includes admission to general sessions, workshops, the exhibit hall and special events.
B. Register early and save $45! .......... US $590 + 4.16% Hawaii Excise Tax = $614.54
BB. Standard registration .......... US $635 + 4.16% Hawaii Excise Tax = $661.42
Degree (please check one):
RN
 LPN
 Tech/Allied Health

Administrator Program

This program does not offer medical education credits. All administrators must be actively employed in a medical practice. Registration includes admission to general program sessions, workshops, the exhibit hall and special events.
C. Register early and save $45! .......... US $590 + 4.16% Hawaii Excise Tax = $614.54
CC. Standard registration .......... US $635 + 4.16% Hawaii Excise Tax = $661.42

Exhibitor Registration

All exhibiting companies must register their attendees through Exhibits Manager, Donna Rosenstock. For exhibitor registration details, please e-mail: drosenstock@slackinc.com, or call: 856-848-1000, ext. 257.

BILLING INFORMATION
   (check if the same as Contact Information at top of page)
*Accountholder's Name:
*Statement Mailing Address:
*City:
*State/Province:
*Country:
*Zip/Postal Code:
I understand and agree to the following:
Effective immediately, requests for refunds must be submitted in writing prior to January 3, 2013; there will be a $200 processing fee applied per person for each cancelled registrant. After January 3, 2013, there will be no refund.

Meeting registration for Hawaiian Eye 2013 does not guarantee accommodations at participating hotels.



Contact Us

Mailing Address: Hawaiian Eye 2013
6900 Grove Road
Thorofare, NJ 08086-9447
Toll-Free Phone: 877-307-5225, ext. 219 or 476
International Phone: +(1) 856-848-1000, ext. 219 or 476
Fax: 856-251-0278
E-mail: meetingregistration@slackinc.com
Office Hours:  9:00 AM - 5:00 PM (EST) Monday - Friday

 


Federal ID #27-4318741

Cancellations: Effective immediately, requests for refunds must be submitted in writing prior to January 3, 2013; there will be a $200 processing fee applied per person for each cancelled registrant. After January 3, 2013, there will be no refund.

ADA Compliance: In compliance with the Americans with Disabilities Act of 1990, we will make all reasonable efforts to accommodate persons with disabilities. Please call with your requests.