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Please provide your inputs in regards to the  DICOTA 2014 Convention Preparations:

1. Your Name

2. State/Country of Residence

3. Your Email

4a. Have you attended a DICOTA Convention before?

4b. If yes, please list year(s) you've attended:

5. Please list up to three topics you would like to be included in this year’s program (whether they’ve been covered before or new ones):

6. Please list up to three presenters you would like to be included in this year’s program (including yourself if you would like to present). Next to presenter’s name, please list their topic of expertise/experience, and their contact information