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* 1. Full Name (First Last)

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* 2. Affiliation (Geology Grad Student, Professor of Computer Science, Undergraduate STS, etc...)

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* 3. Institution

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* 4. E-mail addresss

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* 5. Will you be joining us for lunch (12:30-1:30pm) and the reception (5-7pm)?

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* 6. Would you like vegetarian or vegan meals?

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