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2012 Texas EMS Conference Call for Lectures
Please complete one form for each lecture. Use separate forms for two-hour workshops or preconference classes.
Section 1: Presenter(s)
If yes, co-presenter(s) name(s)
Will co-presenter(s) be paid?
Company name/Address 1
Address 2 :
In order to ensure that we are able to reach you for any changes/updates during conference, please provide a cell number or alternate email address.
Alternate Email Address:
Contact Information for Co-presenter
Assistants, if any, for nametags. Assistants are not paid an honorarium.
If you have any questions please email email@example.com.