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* First Name

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* Last Name

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* Your Job Title

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* Organization

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* Address

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* Email

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* Phone Number

Session Information

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* Session Title

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* Tell us what issues, questions or challenges you will address. What is the expected outcome of the session?

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* Please provide a short description that will be used in the program book. The session description should be less than 75 words. If your session is selected, you will have the opportunity to modify this text.

Session Speakers

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* I need assistance finding speakers for this topic.

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* Speaker #1 First Name

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* Speaker #1 Last Name

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* Speaker #1 Title

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* Speaker #1 Organization

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* Speaker #1 Email

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* Is speaker #1:

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* Speaker #2 First Name

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* Speaker #2 Last Name

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* Speaker #2 Title

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* Speaker #2 Organization

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* Speaker #2 Email

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* Is speaker #2:

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* Speaker #3 First Name

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* Speaker #3 Last Name

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* Speaker #3 Title

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* Speaker #3 Organization

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* Speaker #3 Email

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* Is speaker #3:

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* Will you have additional speakers not listed above?

Session Details

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* Length

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* Format:

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* For people interested in: (select all that apply)

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* Any additional comments or questions?

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* Short Bio or Qualifications (yourself and any identified speakers)

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