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Emergency Contact

Please list first and last name, email, phone number and contact's relation to attendee

In what city and state are you currently based?

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How would you describe your content's focus and subject matter?

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What information are you willing to share with other attendees (select all that apply)?

Please indicate if you have an access need or require an accommodation/service to fully participate at Trending Up:

Please indicate any dietary restrictions:

Please include all restrictions that apply to you, including but not limited to: Vegetarian, Vegan, Gluten Free, Dairy Free, Nut Free, Kosher, Halal

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