SCCOS General Meeting RSVP
This is the RSVP for the February 2016 General CE Dinner Meeting.
Questions: Audrey Louie, OD audreylouieod@gmail.com
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Last Name *
First Name *
Meal Choices
1. BEEF: London Broil
2. SEAFOOD: Seafood Brochette
3. VEGETARIAN: Penne Pasta Primavera
Please select a meal choice. *
NO SUBSTITUTIONS ALLOWED
OD License # *
CA Representative *
Find your California representative at http://findyourrep.legislature.ca.gov/ and check all that apply
Required
Email Address *
(in case we need to contact you)
Membership Status
SCCOS Member: included in dues
COA Member but not SCCOS Member: $55
Non-COA Member: $85
Student/Resident/Speaker/Sponsor: complimentary

Please pay by check or via Paypal (instructions back on the Announcements page) after completing your form submission.
Select your membership status *
If you have an Optometrist as a First-Time Guest, please indicate their name in the comments. Thank you.
If you are not a member, please tell us how you heard about this meeting
Comments
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