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POCDx Speaker Request Form
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What is the speaker's name?
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What is the speaker's school or company affiliation?
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What is the speaker's area of expertise?
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Do you have an existing relationship with this speaker? If so, how?
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What is your name?
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What is your school/company affiliation?
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What is your e-mail address?
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Would you like to be added to our mailing list?
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Do you have any general comments or suggestions about the POCDx Idea Lab
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