Thank you for filling out this form. We look forward to seeing you at an upcoming K or K2R Club meeting!

* 1. First Name

* 2. Last Name

* 3. Email address

* 4. Which club(s) are you interested in?

* 5. Which topics would you like to see presented?

* 6. If you are interested in presenting your specific aims for a lightning round, what is your planned submission date?

Date / Time
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