Thank you for taking the time to let us know whether you’ll be able to join us for the State Plan Summit.
 
On:  
May 4, 2016 at 1:00 p.m. to 6:00 p.m.
May 5, 2016 at 8:00 a.m. to 3:00 p.m.
Location:
Florida Department of Health
Bureau of Emergency Medical Oversight 
Building 4042, Room 301
Tallahassee, FL 32399-1722

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your email address?

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* 4. What is your phone number?

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* 5. Will you be attending this event?

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* 6. Will you be obtaining a hotel room while attending the EMS State Plan Summit?
Travel reimbursement will be provided for official EMSAC members only. All participants must indicate the need for hotel stay.

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