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Прізвище
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Ім'я
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Рід діяльності/Посада
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Назва організації
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Телефон
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Електронна пошта
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Якщо плануєте виступити, вкажіть тему, будь ласка
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Надаю згоду на обробку моїх персональних даних згідно чинного законодавства України.
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