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* 1. Location:
(If in person, provide address, including: street, city, state, zip, name of building or hotel/convention center)
(Specify if online or web meeting)

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* 2. CE Credit (List all designations that apply)

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* 3. Date/Time

Date
Time

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* 4. Sponsoring Organization

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* 5. Event Title

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* 6. Abstract (Describe event in 100 words or less)

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* 7. Speaker(s)

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* 8. Cost

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* 9. Registration Info (provide website)

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* 10. Contact Info (name, email, phone)

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* 11. Deadline for Registration

Date

T