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* 1. Name and Email:

* 2. With what program/department are you affiliated?:

* 3. Are you a:

4. What is your EMPL/STUDENT ID number (7-digit number)?:

5. What is your NetID (e.g., abc123)

6. Please describe the upcoming presentation that you'd like to practice (e.g., job talk, conference talk or interview, paper presentation, lab meeting, poster presentation, etc...):

7. On what date is your presentation?

Date:
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8. What do you hope to learn in this workshop?

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