* 1. Which conference is your presentation abstract being submitted for?

* 2. Last Name:

* 3. First Name:

* 4. Middle Initial:

* 5. Institution:

* 6. Department:

* 7. Job Title/Position:

* 8. Credentials:

* 9. Address

* 10. Area(s) of Research:

* 11. Abstract Title:

* 12. Abstract Text (Less than 300 words):

* 13. Short Biography Paragraph About Yourself:

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