Contact details

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* 1. Full name

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* 2. Address

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* 3. Zip or area code

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* 4. City

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* 5. Telephone (cell)

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* 6. Email address

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* 7. Gender

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* 8. Age

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* 9. Occupation

Conference participation

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* 10. Do you have academic affiliation? Any other?

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* 11. Please, indicate which days you will be attending to the conference

  Morning Afternoon
Monday, October 23
Tuesday, October 24
Wednesday, October 25

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