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Form for Submitting Information About a Blepharospasm Meeting

This form will submit your meeting information both for the Web page and for the BEBRF Newsletter. If you would like the office to send meeting invitation cards, call the office at (409) 832 0788.

Name of meeting
e.g., Decatur, IL
BEBRF Support Group
Date
Time
Location
(include postal code
if known)
Contact: name, phone,
fax, e-mail
The meeting will also be announced on the BEBRF Facebook page. Are you willing to have the above contact info included? Yes No
Additional Information
e.g., speakers, topics
Your name
Your e-mail address
Your phone number
Leave blank

After you have filled in the main fields of the form, click on the "I'm not a robot" box. Click on the matching images and hit Verify. If you do so correctly, you will see a green checkmark. Hit the "Submit" button.



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