ONLINE PAYMENT FORM
OMIG 2020 DUES / MEETING REGISTRATION / LUNCHEON / DONATIONS
Ocular Microbiology and Immunology Group (OMIG) 2020 Annual Meeting
Friday,
November 13, 2020 ,
at
The Mirage, Las Vegas, Nevada
Registration begins at 6:45 a.m.
Annual meeting begins at 7:30 a.m. until 1:00 p.m.
The business luncheon meeting will follow from 1:15 p.m. to 3:00 p.m.
PAYMENT OPTIONS:
$130 Annual Dues with Meeting Registration AND Business Luncheon
$95 Annual Dues with Meeting Registration
$95 Annual Dues Only (not attending Meeting)
$75
Trainee
Dues (Resident/Fellow/Student)
$110
Trainee
Annual Dues / Meeting Registration AND Business Luncheon (Resident/Fellow/Student)
$35 Business Luncheon Only
MAKE A PAYMENT
Registration:
Payment for:
MEMBER Dues w/Mtg Regist. AND Bus Lunch $130.00 USD
MEMBER Dues w/Mtg Registration $95.00 USD
MEMBER Dues Only (Not attending Meeting) $95.00 USD
Business Luncheon Only $35.00 USD
TRAINEE Dues w/Mtg Regist AND Lunch $110.00 USD
TRAINEE Dues w/Mtg Registration $75.00 USD
NOTE: TRAINEE rate is for residents, fellows, and/or students only.
If attending the luncheon, do you have any dietary restrictions?
No
Yes
If yes, please indicate dietary restrictions.
For NAMETAG:
Attendee's Name and Degree(s)
Donations:
Choose One:
Private Donation
Industry Donation
Sponsor Jr Member
I wish to sponsor (name):
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