EPED - Application form

APPLICATION - Every Patient Every Day Program

You are registering to access the Every Patient Every Day program. Please supply requested information below, and we will contact you for payment. Program registrations are processed in monthly batches. Once payment has been made, you will be added to the list of registrations for that month. You will receive your login details shortly after the end of the month and you can then commence the program.
Name of person doing the course
Name of person doing the course

First NameLast Name
Email
This must be a unique personal email address, not a shared or work email
Mobile phone number
Please include area code
Enquiries
FDM Vision Care Research and Training Institute, Inc

Email: fdmvisioncare@gmail.com

Alyanna V. Reyes

+63 2 701 4833

+63 91 7577 3455

Dr. Leilani B. Constante

+63 92 3582 2367
Payments

Must be made to the details below before login is issued.
Course fee: $380 AUD

Deposit to:

Bank of the Philippine Island (BPI )

Account name: FDM Vision Care Research and Training Institute, Inc. (FVCRTI)

Account No. 9651000685
Should be Empty:

APPLICATION - Every Patient Every Day Program