Acadia Eye Conference Registration Form

6th Annual Acadia Eye Conference for Ophthalmic Health Professionals

October 3, 2020 Double Tree 363 Maine Mall Road, South Portland, Maine
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Comments:
To reserve your space, payment and registration is due by September 15. Price is $375 and checks are made to Bryson Taylor Inc. You may pay via PayPal to info@brysontaylor.com. For multiple employees, please list name and cell phone in the box above. Visit our website at www.BrysonTaylor.com/seminars for speakers and times. Email and phone must be that of the attendee. Full brochure is available on our website under Seminars at BrysonTaylor.com
Three Payment options:

1. Payment through Pay Pal paypal.me/BrysonTaylorInc

2. Copy and paste this link to pay on our site: https://www.brysontaylor.com/shop

3. or by mailing a check to Bryson Taylor Inc., 199 New County Road Saco ME 04072.
NOTE: registrants limited to 45, due to Covid-19
Should be Empty:

NOTE: registrants limited to 45, due to Covid-19