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* 1. Check off the lectures you'd like to attend:

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* 2. First Name

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* 3. Last Name

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* 4. Telephone

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* 5. E-Mail Address (This will be used only to remind you of this program.)

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* 6. How did you hear about this program?

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* 7. Please click this checkbox if you want to cancel a registration you made previously.

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