JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Yes, I would like to register for the webinar on 24 June 2021
Theme: Pediatric Eye Care – Coping with The Covid Pandemic in Eye Hospitals worldwide
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Would you like to join The World Association of Eye Hospitals?
*
Yes
No
My eyehospital is already a member of the WAEH
Name
*
Your answer
Name of your Eye Hospital
*
Your answer
Job title
Your answer
I would like to register for this webinar as a:
*
Guest
Host/moderator
Speaker
Required
Are there any themes you would like to present or suggest for upcoming webinars? If yes, which themes would you like to propose?
Your answer
I hereby give permission for my contact details to be included in the WAEH network file. This means that we would like to send you the WAEH newsletter and invite you to upcoming WAEH events
*
Yes
No
Any questions?
Feel free to contact Maaike van Zuilen: @
maaike.vanzuilen@waeh.org
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of philogirl.nl.
Report Abuse
Forms
