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* 1. First and Last Name

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* 2. Will you be attending Breakfast on Friday, February 16, 2018 from 7:00AM-8:00AM?

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* 3. Will you be attending a Committee Meeting on Friday, February 16, 2018 from 8:00AM-5:00PM?

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* 4. Will you be attending  Lunch on Friday, February 16, 2018 from 12:00PM-1:00PM?

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* 5. Will you be attending the Emeritus Lunch on Friday, February 16, 2018 from 12:00PM-1:00PM? (Emeritus Members Only)

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* 6. Will you be attending the Emeritus Reception on Friday, February 16, 2018 from 5:00PM-6:00PM? (Emeritus Members Only)

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* 7. Will your spouse be attending the Emeritus Reception on Friday, February 16, 2018 from 5:00PM-6:00PM? (Emeritus Members Only)

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* 8. Will you be attending the Board reception taking place on Friday, February 16, 2018 from 6:00pm-7:30pm? (Location: TBD)

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* 9. Will your spouse be attending the Board reception taking place on Friday, February 16, 2018 from 6:00pm-7:30pm
(Location: TBD)

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* 10. Will you be attending Breakfast on Saturday, February 17, 2018 from 7:00AM-8:00AM?

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* 11. Will you be attending IMA's Board Meeting on Saturday, February 17, 2018 from 8:00AM-5:00PM?

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* 12. Will you be attending Lunch on Saturday, Februay 17, 2018 from 12:00PM-1:00PM?

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* 13. Do you require any special assistance to fully participate?

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* 14. Please indicate if you have any dietary restrictions.

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* 15. If your spouse is attending the Emeritus and/or Board Reception, please indicate if he/she has any dietary restrictions.

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