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* 1. Student's name?

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* 2. Number attending? Note: Anyone under 18 must be accompanied by a legal guardian.

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* 3. Education Level

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* 4. Email Address? (If under 18, please provide a guardian's email)

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* 5. School name?

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* 6. Area of interest?

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* 7. Do you have any questions/comments for the Humana presenters?

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