Registration Form Neuro-Optometric Rehabilitation Nov 13-16, 2020 (In-person or Virtual)

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Full Name: *

Title: *

Phone: *

E-mail address: *

IN-PERSON, Nov 13-16, 2020; Registration fee is $1,295 per Attendee

VIRTUAL, Nov 13-16, 2020; Registration fee is $995 per Attendee

Work Address *

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Please send your payment (check or money order only, please) payable to:

Cedarville Vision Seminars

P.O. Box 358

Cedarville, OH 45314

For additional information contact:

Anthony Montecalvo, Administrator at VisionTherapySeminars@yahoo.com

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