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This form is to be completed by the presenter(s).

Please complete this form so your presentation may be considered for the conference. If there are co-presenters, please include them below.

Title of Presentation:

Please provide an abstract of a maximum of 350 words to describe your proposed presentation (copy and paste your abstract here):

I represent:

Industry
Higher Education
Research
Environment
Government

Presenter #1

Name:	First   Last
Title:
Organization:
Address:
	City:	State:   AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY	Zip:
Phone #:	Phone   Fax
Email:

Co-Presenter #2 (optional)

Name:	First   Last
Title:
Organization:
Address:
	City:	State:   AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY	Zip:
Phone #:	Phone   Fax
Email: