Fields marked with an * are required

  • Contact Information

  • Date Format: MM slash DD slash YYYY
  • Emergency Contact Information

  • Education

  • Fellowship Training

  • Ophthalmology Work Experience

  • Fellowship Questionnaire

  • References

  • Application Support Documents

  • For Submission By Mail, Fax or Email

    For submission by mail, fax or email send this International Fellows Application to:

    Cure Glaucoma Foundation
    Attn: International Fellows
    10740 N. Central Expressway, Suite 300, Dallas, TX 75231
    (214) 765-9716 Voice
    (214) 360-0083 Fax
    Cure@CureGlaucoma.org