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* 1. I wish to cast my vote IN FAVOR of Kristina M. Deligiannidis, M.D for President Elect

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* 2. I wish to cast my vote IN FAVOR of Jessica Mayer MD for Secretary (as listed below)

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* 3. I wish to cast my vote for Community Member Liasion in favor of

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* 4. I wish to cast my vote for the following (3) Board of Directors for MONA. (please make (3) selections)

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* 5. Please confirm name and email to verify membership status. This information will be confidential and will be used for member verification purposes only.

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