Attendee Information
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Choose Your Day *:
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First Name *:
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Last Name *:
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Title:
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Organization *:
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Street Address *:
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Street Address 2:
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City *:
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State *:
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Country:
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ZIP *:
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Phone *:
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Cell Phone:
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Your Twitter Handle:
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E-Mail *: Please make sure that this is a valid email account. Your receipt for payment and/or the hotel acknowledgement will be sent there.
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If you would like a second copy of your confirmation sent, please enter the e-mail address here:
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Would you like to be contacted by Globetrotter Travel to book airfare (discounts available)?
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Attendee(s) has special needs *:
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Yes No
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If Yes, Please Specify: | |
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Name of Accompanying Spouse/Partner: $100 registration fee for spouse/partner.
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