Event Title (if any)
*
Event Host Organization and Chapter
*
Is the event private and exclusive for your members only?
*
Yes
No
Event Date
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Time
*
Time Zone:
How much time does Mary have for her presentation?
*
Does this virtual event have a hybrid element?
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Yes
No
Event Registration Page
*
Number of expected participant (An estimate is appreciated)
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Conference Link
*
Other information or concerns
Your Name/ Your Events Coordinator
*
Phone number (ONLY for the day of the event, in case there is a last minute question or emergency)
*
Your Events Coordinator's Email
*
Submit