Organizer/Sponsoring Organization
Event Specifications
Speakers

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ASSA Special Event

Organizer/Sponsoring Organization

Organizer

* First Name

Middle Name

* Last Name

Name Suffix

* Email

* Street Address

Street Address 2

* City

* State/Province

* Country/Region

* Postal Code

* Contact Telephone

Contact Fax

Organization

Organization Abbreviation

(Abbreviation is optional and for use online and in the event mobile application.)

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ASSA Special Event

Organizer/Sponsoring Organization