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Present at Talk Tuesday
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1.
Presenter 1: Name and nursing designation:
(Required.)
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2.
Presenter 1: Job Title:
(Required.)
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3.
Presenter 1: Email address:
(Required.)
*
4.
Presenter 1: Phone number:
(Required.)
5.
Presenter 2: Name and nursing designation:
6.
Presenter 2: Job Title:
7.
Presenter 2: Email address:
8.
Presenter 2: Phone number:
9.
Possible Talk Tuesday dates you could present at (please provide three or more):
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10.
Presentation title:
(Required.)
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11.
Presentation description (2-3 sentences):
(Required.)
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12.
Presenter 1 Bio:
(Required.)
13.
Presenter 2 Bio:
14.
Presenter 1 Headshot (picture)
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No file chosen
15.
Presenter 2 Headshot (picture)
Choose File
No file chosen
