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1. First Name (Required.)

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2. Last Name (Required.)

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3. E-mail Address (Required.)

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4. Institution / Organization / Company (Required.)

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5. Type of Institution / Organization / Company (Choose all that apply) (Required.)

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6. Professional Role / Title and Department if applicable (Required.)

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7. Will you be attending the Annual Meeting of the Canadian Academy of Health Sciences?

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8. Will you be attending the light lunch (12:15 pm to 1 pm) following Dr. Lap-Chee Tsui's Lecture at U Ottawa on Sept. 17? (Required.)

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