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Invited Speaker Information Form 2018

Your Name, as you would like it to appear in the program. No degrees. (Examples: "William Durfee" or "Will Durfee"):
Title and Affiliation (Examples "Mechanical Engineering, University of Minnesota" or "Medtronic" or "Cardiac Rhythm Management, Boston Scientific"):
Email Address:
Phone Number
Title of Session:
Presentation Title:
Speaker Bio (60 words or less):
Presentation Abstract (80 words or less):
Name and contact information of person filling out this form (if different than above):
Featured Speakers Only: If you have been instructed, please upload photo here (.jpg preferred)

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