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ATTENDEE INFORMATION
REGISTRATION RECORD
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Your Industry*
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Addiction & Substance Abuse
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Source Detail
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Is this your first-time attending Impact Nation?*
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Campaign (Attribution)
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How did you hear about Impact Nation?*
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Email
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Relias Partner
Relias.com
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Relias Staff
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Default Campaign Assignment Id
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Staff Member Name
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Partner Referral Code
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Vertical
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Post-Acute Care
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Attendee Information
Reference Number
Work Email Address
First Name
Last Name