MainTECHNICIAN PROGRAM REGISTRATION Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. - Step 1 of 2REGISTER: *Technician Program - $195.00Luncheon - $55.00Luncheon is included in the Technician Program registration fee. Payment is required if you wish to add an additional lunch. is Contact Name Attendee Name *FirstLastAttendee Email *The Attendee is a Wills Eye Hospital Employee *YesNoAttendee is with the following Wills Eye Service/Department/Practice *CPECCorneaGlaucomaNeuro-OphthalmologyOculoplasticsOncologyPathologyPediatricsRetinaBailey WeberKing of PrussiaPaoliRittenhouse/HarrisOtherIf Other, please specify the Wills Eye Department/Service/Practice *I will pay by:Credit CardCheckNextPAYMENT DETAILS Total$0.00To pay by check: Send payment to: Wills Eye Alumni Society 840 Walnut Street, 8th Floor Philadelphia, PA 19107 Credit Card Information *We accept Visa, Mastercard, American Express, and Discover.Contact Name *FirstLastContact Email *Company/Organization/Practice NameQuestions about registration? Please contact Susan Umfer, sumfer@willseye.org SUBMIT
