First Name
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	Last Name
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	Title
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	Company/Organization
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	Email
	Enter a valid email.
	*Required*
	LPAC Member or Observer
	Yes No
	*Required
	Are you attending In-Person or Virtual?
	In-Person Virtual
	*Required
	Will you be attending the dinner on July 17th?
	Yes No
	If Yes, do you have any dietary restrictions?
	Do you require hotel accommodations?
	Yes No
	Are there any topics or questions that you would like to see addressed at the conference?