LATPO

Louisiana Association of Technical Personnel in Ophthalmology

 

 

Registration for LATPO Annual Spring Meeting 2010

Course Fee:   $75.00   (includes membership fee)

                         $50.00 (for members only)

Name:___________________________________

Address:__________________________________

_________________________________________

EMAIL ADDRESS:_____________________________

Telephone #:______________________________

Employer Name:___________________________

JCAHPO Certified: __________No   __________COA

________COT   ________COMT ________Other

Make check payable to:  LATPO

70123 Kelly Rd.,  Mandeville, LA   70471

contact:  loyacano_n@yahoo.com for questions