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* 1. First Name of Presenter

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* 2. Last name of the presenter

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* 3. Email Address

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* 4. University Affiliation

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* 5. Please indicate your preferred method of presenting.

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* 6. Please indicate the title of your presentation.

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* 7. Please provide an the abstract for your presentation (max. 150 words). Please ensure that it includes a description of the research being presented as well as any preliminary statistical analysis (if applicable).

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* 8. Do you have any dietary restrictions?

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* 9. Do you have any special needs and/or requirements?

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* 10. Additional comments:

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