Please do not use the following punctuation in fields quotation marks, apostrophies, commas or periods

Make sure each required field has valid information

Persons under 16 will not be admitted to any functions

First

Last

Address

Suite, Apt, etc. (Optional)

E-mail Address

City

State or Province

Zip or Postal Code

Country

Telephone

Including yourself, how many people will attend the Friday Evening Reception
at the Millennium Durham Hotel

Including yourself, how many people will attend the Symposium on Saturday
at the The Albert Eye Research Institute (AERI ) Auditorium?

Please do not use any punctuation marks in the name, city or state fields below

Enter Name of each person being registered including you

Enter city for each person

Enter state for each person

Person 1 Name

Person 1 City

Person 1 State

Person 2 Name

Person 2 City

Person 2 State

Person 3 Name

Person 3 City

Person 3 State

Person 4 Name

Person 4 City

Person 4 State

Note:

To best serve you, we need to understand your housing and transport plans.

Pick ONLY ONE of the Radio Buttons Below

I will be staying at the Millennium Durham Hotel and expect to have our own transportation for my party.

I will be staying at the Millennium Durham Hotel and will need transportation to and from the Symposium for our party

I will not be staying at the Millennium Hotel Durham.

Absolutely Last Question:

If you were given a group code, please enter it in the field on the right.

My Group Code is: 2 Characters only

When you have completed the registration process, you will be taken to a page where you may pay on line via Paypal’s secure site..
You will also receive instructions to pay by check or international money order.

Please note that space is very limited and your reservation is not final
until your payment is received

PayPal pays fastest!

When all fields have been entered

Click the Submit Button (only once please),

Copyright 2009 - The Corneal Dystrophy Foundation All rights reserved. No part of this website may, for commercial, profit-making or other non-personal purposes, be reproduced in any form, or stored in a database or retrieval system, or transmitted or distributed in any form by any means, electronic, mechanical photocopying, recording or otherwise without prior written or electronic permission of the Author, Submit all inquiries to said person via email to the foundation’s Executive Director