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Prefix

First Name*

Last Name*

Email*

Confirm Email*

Mot de passe*

Confirmer le mot de passe*

Company/Organisation/Affiliation

Phone

Job Title/Role

Address Line 1*

Address Line 2

City*

Province / Région

Postal Code/Zip Code

Gender I Identity With*

---IMPORTANT! Presenter Bio and Photo---

If you will be participating in a presentation, panel, workshop, etc., you must attach a hi-res photo and bio (up to 100 words) in order for your abstract to be accepted.

Presenter's Photo (hi-res)

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Acceptable file size : 10 MBAcceptable file types : .png, .jpeg, .jpg

Presenter's Bio (up to 100 words)(Jusqu'à 100 Mots)

Your Twitter Handle

Your Instagram Handle