AMO Global Equipment Education Course Registration - Abbott Medical Optics Inc. (AMO)

Global Equipment Education > Student Registration Form

AMO Global Equipment Education Course Registration Form

Note: All student information must be complete in order to register for courses. Completion of this form does not mean automatic enrollment of the student into any course. Enrollment in courses is subject to review and approval by the AMO Global Equipment Education department. All courses have a cost associated with them and is subject to change.

Student Information
First Name	Please enter your first name.
Last Name	Please enter your last name.
Birthdate (mm/dd/yy)	A value is required.Invalid format.A value is required.Invalid format.
E-Mail	Please enter your E-Mail address. Note: Please enter your individual/personal E-Mail address.
Courses Interested in Attending (Multiple Selections OK)	STAR S4 IR® & WaveScan® Training Certification STAR S4 IR® & WaveScan® Mobile Laser Operator STAR S4 IR® & WaveScan® Technical Overview STAR S4 IR® & WaveScan® Product Demo STAR S4 IR® & WaveScan® Bio-Med Certification SOVEREIGN® Compact Training and Certification SOVEREIGN® Training and Certification SOVEREIGN® Bio-Med Certification SOVEREIGN® Compact Bio-Med Certification WhiteStar Signature® Training and Certification WhiteStar Signature® and SOVEREIGN® Compact Technical Overview WhiteStar Signature® Bio-Med Certification Phaco Technical Overview Phaco Product Demo iFS Laser Overview, Installation and Calibration FS-iFS Mobile Laser Operator FS-iFS Technical Overview FS-iFS Product Demo FS Laser Training and Certification FS Laser Model 1 (FS1) Differences
Abbott UPI (if AMO employee)	Please enter your 8-digit UPI or leave this field blank.
Department Number (if AMO employee)
Address	Please enter your address.
City	Please enter your city.
State
Country	Please select a country.Please select an item.
ZIP / Postal Code	Please enter your ZIP code.
Phone	Please enter your office phone number.
Work Location	A value is required.
Current Job Title	A value is required.
Student Experience
Excimer Equipment	Please select a valid item. Please select an item.
Phaco Equipment	Please select a valid item. Please select an item.
Femto Equipment	Please select a valid item. Please select an item.
Ophthalmologic Equipment	Please select a valid item. Please select an item.
Student Emergency Contact Information
Full Name	A value is required.
Phone	A value is required.
Relationship to Student
Manager's Name	A value is required.
Manager's Phone	A value is required.
Manager's E-Mail	A value is required. Invalid format.
Distributorship/Employer Information
Name	A value is required.
Street	A value is required.
City	A value is required.
ZIP / Postal Code	A value is required.
Country	Please select a country. Please select an item.
E-Mail	A value is required. Invalid format.
Phone	A value is required.

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AMO Global Equipment Education Course Registration Form

Student Information

Student Experience

Student Emergency Contact Information

Distributorship/Employer Information