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* 1. I will be attending:

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* 2. Email address:

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* 3. Name:

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* 4. Current position:

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* 5. If resident/fellow: Specialty?

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* 6. Institution/Organization:

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* 7. I would like to be included in future MUSC AMSRO events:

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* 8. Do you have any questions you would like to ask?

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