Acadia Eye Conference Registration Form

10th Annual Acadia Eye Conference for Ophthalmic Health Professionals

Saturday, October 26, 2024 on a Zoom Webinar
First & Last Name
Payment Amount
$150 for the course. If there is more than one attendee, make out the form for each person.
Email of Attendee*
attendees email, where we will send the invitation to the Zoom
Billing Email*
Email of the person that is paying the invoice
Phone
include area code
Full Address
Street, City, State and Zipcode
Medical Practice
Three ways to pay

Payment options:

Once we receive this form, you will receive an email invoice from Quickbooks. You may:

1. Mail: check to Bryson Taylor Inc., 199 New County Road Saco ME 04072

2. Venmo to @Deb-Landry

3. Pay the invoice with a credit card payment by clicking on the invoice

We no longer accept PayPal
Comments: Please add billing email in the comments if different than the registrant. Payment and registration is due at time of invoice. Until payment is made no registration logon information will be given. If you want to register more than one person, add all the names in the box below, list multiple employees' names, emails, and cell phones. We will send you an invoice for each person on one invoice. Bryson Taylor is not responsible for technical issues on the attendee's end. One viewer per email. Visit our website at www.BrysonTaylor.com/seminars for the brochure, speakers, and times. A full brochure is available on our website under Seminars at BrysonTaylor.com. Credits are awarded via email once you have completed the program. Note, registrant is responsible for payment and we will not give information to log into the meeting if the payment is not received or past due. Make sure to have your payment made upon receipt.
Signature

Clear
Should be Empty:

10th Annual Acadia Eye Conference for Ophthalmic Health Professionals