OB 2024 Congress Dinner

Congress DINNER – Order Form –

SUBMISSION DEADLINE: 14th November 2025 OR until tickets sell out.

Date: Thursday, 27 November 2025

Time: 19:30 - 24:00 (Midnight)

Venue: Le Plaza Hotel Brussels, Adolphe Maxlaan 118/126, 1000 Brussel, Belgium.

Price per ticket: 100 EUR

Please note that the Industry can only buy tickets for their staff. Tickets can not be used to distribute to ophthalmologist as a commercial gesture to non-congress participants.

PLEASE SELECT THE NUMBER OF TICKETS YOU WANT TO ORDER:

NOTE: Maximum number per company is 5 tickets

Tickets ordered for the company : *

Company Name

Name contact person ordering these tickets*

Contact person first nameContact person last name

Contact Person Email*

example@example.com

INVOICE ADDRESS

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PO Number if needed: