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* 1. First Name of presenting author

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* 2. Last Name of presenting author

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* 3. Credentials of presenting author

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* 4. Institution

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* 5. City

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* 6. State

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* 7. Country

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* 8. Email

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* 9. Abstract Title

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* 10. Abstract Body (350 words or less)

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* 11. How long would you like to present?

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* 12. References

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* 13. Grant Support

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