The National Foundation for Eye Research

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Meeting Registration Form

REGISTRATION FORM

2012 International Conference on the Lens

See below for the Program and Hotel Reservation Form

January 15 (Sunday) to January 20 (Friday)

78-6740 Alii Drive
Kailua-Kona, Hawaii, 96740
Ph: 808 322-3441

* Required information

REGISTRANT'S INFORMATION

Your Name and Institute:

First Name*

Last Name*

Suffix

Institute*

(As it should appear on the name tag)

Your Mailing Address:

Line 1 (Street or PO Box)*

Line 2 (Suite / Apt# / Floor)

City*

State *

Zip*

Country

If outside US & Canada, you may enter your city and state information in the City field and then set the State field to ZZ. If US resident, leave the country field blank.

Contact Information:

	Telephone*	Fax
	(Example: 555-555-5555x555)

Email*

	Re-enter Email:*
	Remarks

Meeting Related Information:

Participation Charge:*

Participant(s):	x $350.00 =
Accompanying Adult(s):	x $150.00 =
Staying at Ohana Keauhou Beach Resort?:* (There is a surcharge of $200 for those not staying at Outrigger Keauhou Beach Resort)		Yes No
Total Amount:

(Calculate your participation charge from above table by entering the number of participant(s) and/or number of accompanying adult(s).)

Names of Accompanying Adults:

(Type the names separated by comma. e.g. John A. Stewart, Zack Smith)

	Attend Banquet:* Yes No	Participant: Fish Steak Vegetarian	Accompanying Adult: Fish Steak Vegetarian
	Attend Luau:* Yes No	Attend Reception:* Yes No

Meeting Program (pdf, 1661 KB)
Hotel Reservation Form (doc, 81 KB)

International Conference on the Lens January 15-20, 2012 Kona, Hawaii

Lens/Cataract Topics for this Meeting include: Animal Models, Biochemistry, Cataract, Crystallins, Cell Biology, Developmental Biology, Development and Disease, Gap Junctions, Genetics
Growth Factors. Molecular Biology, Oxidation, Pharmacology, Physiology, Posterior Capsular Opacification, Protein Modifications, Signaling, Structure, Transport

International Conference on the Lens