2021 Speaker Acceptance FormPlease enable JavaScript in your browser to complete this form.Name *FirstLastPlease enter your first and last name (including your professional credentials), as indicated in the boxesEmail *EmailConfirm EmailAbstract Title - PLEASE SUBMIT A SEPARATE FORM FOR EACH OF YOUR ABSTRACTS ACCEPTED *Presentation Mode *I will present at the ASCIP 2021 ConferenceI must respectfully decline to present in 2021 Indicate Presentation Type *I will present live from Reno, NVI will present virtuallyPlease let us know why you are declining. *Permission to record presentation for enduring content. *I give my permission for ASCIP to record and use my presentation for enduring content.I do not grant ASCIP permission to record my presentation for enduring content.I attest that the material in my presentation is original content and that I have permission of the author to use/share/distribute all text, images or other material that may have come from other sources. *YesNoI understand that I must register for the conference in order to present. (Except for notified award speakers.) *YesNoSubmit