event.on24.com
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199.83.44.71
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Submitted URL: https://acimarket.com/c/1707511/e168b70d7db6c835/6
Effective URL: https://event.on24.com/wcc/r/3359607/E5E746072AD98F72A555FED2D34BA036?partnerref=CPCISSUEEP
Submission: On September 06 via manual from US
Effective URL: https://event.on24.com/wcc/r/3359607/E5E746072AD98F72A555FED2D34BA036?partnerref=CPCISSUEEP
Submission: On September 06 via manual from US
Form analysis
1 forms found in the DOMPOST /eventRegistration/eventRegistrationServlet
<form class="form-horizontal reg-form" novalidate="true" method="POST" action="/eventRegistration/eventRegistrationServlet">
<div class="js-fields-container">
<!-- Here are going to be placed the registration fields -->
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="email" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="email" id="email" autocomplete="email" aria-label="Business Email"
required="required" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Business Email</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="firstname" id="firstname" autocomplete="given-name" aria-label="First Name"
required="required" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">First Name</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="lastname" id="lastname" autocomplete="family-name" aria-label="Last Name"
required="required" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Last Name</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="job_title" id="job_title" autocomplete="organization-title" aria-label="Title"
required="required" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Title</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="company" id="company" autocomplete="organization" aria-label="Company Name"
required="required" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Company Name</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="address_street1" id="address_street1" autocomplete="address-line1"
aria-label="Street Address 1" required="required" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Street Address 1</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="address_street2" id="address_street2" autocomplete="address-line2"
aria-label="Street Address 2" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Street Address 2</span><span class="required data-required"></span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="city" id="city" autocomplete="address-level2" aria-label="City" required="required"
style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">City</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="margin-bottom: 12px;">
<div class="col-xs-12">
<label class="drop-down-label js-label" for="state"><span class="data-label">State/Province</span><span class="required data-required">*</span></label>
<select class="form-control input-sm js-select data-select" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" name="state" id="state" required="required">
<option value="" selected=""> Please Select One </option>
<option value="Non-US"> Non-US </option>
<option value="Alabama"> Alabama </option>
<option value="Alaska"> Alaska </option>
<option value="Arizona"> Arizona </option>
<option value="Arkansas"> Arkansas </option>
<option value="California"> California </option>
<option value="Colorado"> Colorado </option>
<option value="Connecticut"> Connecticut </option>
<option value="Delaware"> Delaware </option>
<option value="District of Columbia"> District of Columbia </option>
<option value="Florida"> Florida </option>
<option value="Georgia"> Georgia </option>
<option value="Hawaii"> Hawaii </option>
<option value="Idaho"> Idaho </option>
<option value="Illinois"> Illinois </option>
<option value="Indiana"> Indiana </option>
<option value="Iowa"> Iowa </option>
<option value="Kansas"> Kansas </option>
<option value="Kentucky"> Kentucky </option>
<option value="Louisiana"> Louisiana </option>
<option value="Maine"> Maine </option>
<option value="Maryland"> Maryland </option>
<option value="Massachusetts"> Massachusetts </option>
<option value="Michigan"> Michigan </option>
<option value="Minnesota"> Minnesota </option>
<option value="Mississippi"> Mississippi </option>
<option value="Missouri"> Missouri </option>
<option value="Montana"> Montana </option>
<option value="Nebraska"> Nebraska </option>
<option value="Nevada"> Nevada </option>
<option value="New Hampshire"> New Hampshire </option>
<option value="New Jersey"> New Jersey </option>
<option value="New Mexico"> New Mexico </option>
<option value="New York"> New York </option>
<option value="North Carolina"> North Carolina </option>
<option value="North Dakota"> North Dakota </option>
<option value="Ohio"> Ohio </option>
<option value="Oklahoma"> Oklahoma </option>
<option value="Oregon"> Oregon </option>
<option value="Pennsylvania"> Pennsylvania </option>
<option value="Puerto Rico"> Puerto Rico </option>
<option value="Rhode Island"> Rhode Island </option>
<option value="South Carolina"> South Carolina </option>
<option value="South Dakota"> South Dakota </option>
<option value="Tennessee"> Tennessee </option>
<option value="Texas"> Texas </option>
<option value="Utah"> Utah </option>
<option value="Vermont"> Vermont </option>
<option value="Virginia"> Virginia </option>
<option value="Washington"> Washington </option>
<option value="West Virginia"> West Virginia </option>
<option value="Wisconsin"> Wisconsin </option>
<option value="Wyoming"> Wyoming </option>
<option value="AA"> AA </option>
<option value="AE"> AE </option>
<option value="AP"> AP </option>
<option value="American Samoa"> American Samoa </option>
<option value="Federated States of Micronesia"> Federated States of Micronesia </option>
<option value="Guam"> Guam </option>
<option value="Marshall Islands"> Marshall Islands </option>
<option value="Northern Mariana Islands"> Northern Mariana Islands </option>
<option value="Palau"> Palau </option>
<option value="Virgin Islands"> Virgin Islands </option>
<option value="Alberta"> Alberta </option>
<option value="British Columbia"> British Columbia </option>
<option value="Manitoba"> Manitoba </option>
<option value="New Brunswick"> New Brunswick </option>
<option value="Newfoundland and Labrador"> Newfoundland and Labrador </option>
<option value="Northwest Territories"> Northwest Territories </option>
<option value="Nova Scotia"> Nova Scotia </option>
<option value="Nunavut"> Nunavut </option>
<option value="Ontario"> Ontario </option>
<option value="Prince Edward Island"> Prince Edward Island </option>
<option value="Quebec"> Quebec </option>
<option value="Saskatchewan"> Saskatchewan </option>
<option value="Yukon"> Yukon </option>
</select>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="text" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="zip" id="zip" autocomplete="postal-code" aria-label="Postal Code"
required="required" style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Postal Code</span><span class="required data-required">*</span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="margin-bottom: 12px;">
<div class="col-xs-12">
<label class="drop-down-label js-label" for="country"><span class="data-label">Country</span><span class="required data-required">*</span></label>
<select class="form-control input-sm js-select data-select" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" name="country" id="country" required="required" previousvalue="United States">
<option value="Afghanistan"> Afghanistan </option>
<option value="Albania"> Albania </option>
<option value="Algeria"> Algeria </option>
<option value="American Samoa"> American Samoa </option>
<option value="Andorra"> Andorra </option>
<option value="Angola"> Angola </option>
<option value="Anguilla"> Anguilla </option>
<option value="Antarctica"> Antarctica </option>
<option value="Antigua and Barbuda"> Antigua and Barbuda </option>
<option value="Argentina"> Argentina </option>
<option value="Armenia"> Armenia </option>
<option value="Aruba"> Aruba </option>
<option value="Ashmore and Cartier Islands"> Ashmore and Cartier Islands </option>
<option value="Australia"> Australia </option>
<option value="Austria"> Austria </option>
<option value="Azerbaijan"> Azerbaijan </option>
<option value="Bahamas, The"> Bahamas, The </option>
<option value="Bahrain"> Bahrain </option>
<option value="Baker Island"> Baker Island </option>
<option value="Bangladesh"> Bangladesh </option>
<option value="Barbados"> Barbados </option>
<option value="Bassas da India"> Bassas da India </option>
<option value="Belarus"> Belarus </option>
<option value="Belgium"> Belgium </option>
<option value="Belize"> Belize </option>
<option value="Benin"> Benin </option>
<option value="Bermuda"> Bermuda </option>
<option value="Bhutan"> Bhutan </option>
<option value="Bolivia"> Bolivia </option>
<option value="Bosnia and Herzegovina"> Bosnia and Herzegovina </option>
<option value="Botswana"> Botswana </option>
<option value="Bouvet Island"> Bouvet Island </option>
<option value="Brazil"> Brazil </option>
<option value="British Indian Ocean Territory"> British Indian Ocean Territory </option>
<option value="British Virgin Islands"> British Virgin Islands </option>
<option value="Brunei"> Brunei </option>
<option value="Bulgaria"> Bulgaria </option>
<option value="Burkina Faso"> Burkina Faso </option>
<option value="Burundi"> Burundi </option>
<option value="Cambodia"> Cambodia </option>
<option value="Cameroon"> Cameroon </option>
<option value="Canada"> Canada </option>
<option value="Cape Verde"> Cape Verde </option>
<option value="Cayman Islands"> Cayman Islands </option>
<option value="Central African Republic"> Central African Republic </option>
<option value="Chad"> Chad </option>
<option value="Chile"> Chile </option>
<option value="China"> China </option>
<option value="Christmas Island"> Christmas Island </option>
<option value="Clipperton Island"> Clipperton Island </option>
<option value="Cocos (Keeling) Islands"> Cocos (Keeling) Islands </option>
<option value="Colombia"> Colombia </option>
<option value="Comoros"> Comoros </option>
<option value="Congo, Democratic Republic of"> Congo, Democratic Republic of </option>
<option value="Cook Islands"> Cook Islands </option>
<option value="Costa Rica"> Costa Rica </option>
<option value="Cote d'Ivoire"> Cote d'Ivoire </option>
<option value="Croatia"> Croatia </option>
<option value="Cyprus"> Cyprus </option>
<option value="Czech Republic"> Czech Republic </option>
<option value="Denmark"> Denmark </option>
<option value="Djibouti"> Djibouti </option>
<option value="Dominica"> Dominica </option>
<option value="Dominican Republic"> Dominican Republic </option>
<option value="Ecuador"> Ecuador </option>
<option value="Egypt"> Egypt </option>
<option value="El Salvador"> El Salvador </option>
<option value="Equatorial Guinea"> Equatorial Guinea </option>
<option value="Eritrea"> Eritrea </option>
<option value="Estonia"> Estonia </option>
<option value="Ethiopia"> Ethiopia </option>
<option value="Europa Island"> Europa Island </option>
<option value="Falkland Islands"> Falkland Islands </option>
<option value="Faroe Islands"> Faroe Islands </option>
<option value="Fiji"> Fiji </option>
<option value="Finland"> Finland </option>
<option value="France"> France </option>
<option value="French Guiana"> French Guiana </option>
<option value="French Polynesia"> French Polynesia </option>
<option value="French Southern and Antarctic"> French Southern and Antarctic </option>
<option value="Gabon"> Gabon </option>
<option value="Gambia, The"> Gambia, The </option>
<option value="Gaza Strip"> Gaza Strip </option>
<option value="Georgia"> Georgia </option>
<option value="Germany"> Germany </option>
<option value="Ghana"> Ghana </option>
<option value="Gibraltar"> Gibraltar </option>
<option value="Glorioso Islands"> Glorioso Islands </option>
<option value="Greece"> Greece </option>
<option value="Greenland"> Greenland </option>
<option value="Grenada"> Grenada </option>
<option value="Guadeloupe"> Guadeloupe </option>
<option value="Guam"> Guam </option>
<option value="Guatemala"> Guatemala </option>
<option value="Guernsey"> Guernsey </option>
<option value="Guinea"> Guinea </option>
<option value="Guinea-Bissau"> Guinea-Bissau </option>
<option value="Guyana"> Guyana </option>
<option value="Haiti"> Haiti </option>
<option value="Heard and McDonald Islands"> Heard and McDonald Islands </option>
<option value="Holy See (Vatican City)"> Holy See (Vatican City) </option>
<option value="Honduras"> Honduras </option>
<option value="Hong Kong"> Hong Kong </option>
<option value="Howland Island"> Howland Island </option>
<option value="Hungary"> Hungary </option>
<option value="Iceland"> Iceland </option>
<option value="India"> India </option>
<option value="Indonesia"> Indonesia </option>
<option value="Iraq"> Iraq </option>
<option value="Ireland"> Ireland </option>
<option value="Israel"> Israel </option>
<option value="Italy"> Italy </option>
<option value="Jamaica"> Jamaica </option>
<option value="Jan Mayen"> Jan Mayen </option>
<option value="Japan"> Japan </option>
<option value="Jarvis Island"> Jarvis Island </option>
<option value="Jersey"> Jersey </option>
<option value="Johnston Atoll"> Johnston Atoll </option>
<option value="Jordan"> Jordan </option>
<option value="Juan de Nova Island"> Juan de Nova Island </option>
<option value="Kazakhstan"> Kazakhstan </option>
<option value="Kenya"> Kenya </option>
<option value="Kingman Reef"> Kingman Reef </option>
<option value="Kiribati"> Kiribati </option>
<option value="Korea, South"> Korea, South </option>
<option value="Kuwait"> Kuwait </option>
<option value="Kyrgyzstan"> Kyrgyzstan </option>
<option value="Lao People's Democratic Republic"> Lao People's Democratic Republic </option>
<option value="Latvia"> Latvia </option>
<option value="Lebanon"> Lebanon </option>
<option value="Lesotho"> Lesotho </option>
<option value="Liberia"> Liberia </option>
<option value="Libya"> Libya </option>
<option value="Liechtenstein"> Liechtenstein </option>
<option value="Lithuania"> Lithuania </option>
<option value="Luxembourg"> Luxembourg </option>
<option value="Macao"> Macao </option>
<option value="Macedonia"> Macedonia </option>
<option value="Madagascar"> Madagascar </option>
<option value="Malawi"> Malawi </option>
<option value="Malaysia"> Malaysia </option>
<option value="Maldives"> Maldives </option>
<option value="Mali"> Mali </option>
<option value="Malta"> Malta </option>
<option value="Man, Isle of"> Man, Isle of </option>
<option value="Marshall Islands"> Marshall Islands </option>
<option value="Martinique"> Martinique </option>
<option value="Mauritania"> Mauritania </option>
<option value="Mauritius"> Mauritius </option>
<option value="Mayotte"> Mayotte </option>
<option value="Mexico"> Mexico </option>
<option value="Micronesia, Federated States"> Micronesia, Federated States </option>
<option value="Midway Islands"> Midway Islands </option>
<option value="Moldova"> Moldova </option>
<option value="Monaco"> Monaco </option>
<option value="Mongolia"> Mongolia </option>
<option value="Montenegro"> Montenegro </option>
<option value="Montserrat"> Montserrat </option>
<option value="Morocco"> Morocco </option>
<option value="Mozambique"> Mozambique </option>
<option value="Myanmar"> Myanmar </option>
<option value="Namibia"> Namibia </option>
<option value="Nauru"> Nauru </option>
<option value="Navassa Island"> Navassa Island </option>
<option value="Nepal"> Nepal </option>
<option value="Netherlands"> Netherlands </option>
<option value="Netherlands Antilles"> Netherlands Antilles </option>
<option value="New Caledonia"> New Caledonia </option>
<option value="New Zealand"> New Zealand </option>
<option value="Nicaragua"> Nicaragua </option>
<option value="Niger"> Niger </option>
<option value="Nigeria"> Nigeria </option>
<option value="Niue"> Niue </option>
<option value="Norfolk Island"> Norfolk Island </option>
<option value="Northern Mariana Islands"> Northern Mariana Islands </option>
<option value="Norway"> Norway </option>
<option value="Oman"> Oman </option>
<option value="Pakistan"> Pakistan </option>
<option value="Palau"> Palau </option>
<option value="Palmyra Atoll"> Palmyra Atoll </option>
<option value="Panama"> Panama </option>
<option value="Papua New Guinea"> Papua New Guinea </option>
<option value="Paracel Islands"> Paracel Islands </option>
<option value="Paraguay"> Paraguay </option>
<option value="Peru"> Peru </option>
<option value="Philippines"> Philippines </option>
<option value="Pitcairn Islands"> Pitcairn Islands </option>
<option value="Poland"> Poland </option>
<option value="Portugal"> Portugal </option>
<option value="Puerto Rico"> Puerto Rico </option>
<option value="Qatar"> Qatar </option>
<option value="Reunion"> Reunion </option>
<option value="Romania"> Romania </option>
<option value="Russia"> Russia </option>
<option value="Rwanda"> Rwanda </option>
<option value="Saint Helena"> Saint Helena </option>
<option value="Saint Kitts and Nevis"> Saint Kitts and Nevis </option>
<option value="Saint Lucia"> Saint Lucia </option>
<option value="Saint Pierre and Miquelon"> Saint Pierre and Miquelon </option>
<option value="Saint Vincent and Grenadines"> Saint Vincent and Grenadines </option>
<option value="Samoa"> Samoa </option>
<option value="San Marino"> San Marino </option>
<option value="Sao Tome and Principe"> Sao Tome and Principe </option>
<option value="Saudi Arabia"> Saudi Arabia </option>
<option value="Senegal"> Senegal </option>
<option value="Serbia"> Serbia </option>
<option value="Seychelles"> Seychelles </option>
<option value="Sierra Leone"> Sierra Leone </option>
<option value="Singapore"> Singapore </option>
<option value="Slovakia"> Slovakia </option>
<option value="Slovenia"> Slovenia </option>
<option value="Solomon Islands"> Solomon Islands </option>
<option value="Somalia"> Somalia </option>
<option value="South Africa"> South Africa </option>
<option value="South Georgia"> South Georgia </option>
<option value="South Sudan"> South Sudan </option>
<option value="Spain"> Spain </option>
<option value="Spratly Islands"> Spratly Islands </option>
<option value="Sri Lanka"> Sri Lanka </option>
<option value="Suriname"> Suriname </option>
<option value="Svalbard"> Svalbard </option>
<option value="Swaziland"> Swaziland </option>
<option value="Sweden"> Sweden </option>
<option value="Switzerland"> Switzerland </option>
<option value="Taiwan"> Taiwan </option>
<option value="Tajikistan"> Tajikistan </option>
<option value="Tanzania"> Tanzania </option>
<option value="Thailand"> Thailand </option>
<option value="Timor-Leste"> Timor-Leste </option>
<option value="Togo"> Togo </option>
<option value="Tokelau"> Tokelau </option>
<option value="Tonga"> Tonga </option>
<option value="Trinidad and Tobago"> Trinidad and Tobago </option>
<option value="Tromelin Island"> Tromelin Island </option>
<option value="Tunisia"> Tunisia </option>
<option value="Turkey"> Turkey </option>
<option value="Turkmenistan"> Turkmenistan </option>
<option value="Turks and Caicos Islands"> Turks and Caicos Islands </option>
<option value="Tuvalu"> Tuvalu </option>
<option value="Uganda"> Uganda </option>
<option value="Ukraine"> Ukraine </option>
<option value="United Arab Emirates"> United Arab Emirates </option>
<option value="United Kingdom"> United Kingdom </option>
<option value="United States" selected=""> United States </option>
<option value="Uruguay"> Uruguay </option>
<option value="Uzbekistan"> Uzbekistan </option>
<option value="Vanuatu"> Vanuatu </option>
<option value="Venezuela"> Venezuela </option>
<option value="Vietnam"> Vietnam </option>
<option value="Virgin Islands"> Virgin Islands </option>
<option value="Wake Atoll"> Wake Atoll </option>
<option value="Wallis and Futuna"> Wallis and Futuna </option>
<option value="West Bank"> West Bank </option>
<option value="Western Sahara"> Western Sahara </option>
<option value="Yemen"> Yemen </option>
<option value="Zambia"> Zambia </option>
<option value="Zimbabwe"> Zimbabwe </option>
</select>
</div>
</div>
<div class="row has-feedback reg-field" style="padding-top: 6px; margin-bottom: 12px;">
<div class="col-xs-12">
<!--<label class ="visually-hidden"><span class="data-label"></span></label>-->
<input type="tel" class="form-control input-sm js-input data-input" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" maxlength="500" name="work_phone" id="work_phone" autocomplete="tel" aria-label="Business Phone"
style="z-index: 10;">
<label class="placeholder-label js-label" aria-hidden="true"><span class="data-label">Business Phone</span><span class="required data-required"></span></label>
</div>
</div>
<div class="row has-feedback reg-field" style="margin-bottom: 12px;">
<div class="col-xs-12">
<label class="drop-down-label js-label" for="std1"><span class="data-label">What best describes your business/industry?</span><span class="required data-required"></span></label>
<select class="form-control input-sm js-select data-select" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" name="std1" id="std1">
<option value="" selected=""> Please Select One: </option>
<option value="Analytical Testing Labs/Contract Laboratory"> Analytical Testing Labs/Contract Laboratory </option>
<option value="Consulting"> Consulting </option>
<option value="University"> University </option>
<option value="Cultivation/Grow Facility"> Cultivation/Grow Facility </option>
<option value="Dispensary"> Dispensary </option>
<option value="Medical/Clinical Lab"> Medical/Clinical Lab </option>
<option value="Government"> Government </option>
<option value="Manufacturing/Processing/Extraction"> Manufacturing/Processing/Extraction </option>
<option value="Other"> Other </option>
</select>
</div>
</div>
<div class="row has-feedback reg-field" style="margin-bottom: 12px;">
<div class="col-xs-12">
<label class="drop-down-label js-label" for="std2"><span class="data-label">What is your status/role?</span><span class="required data-required"></span></label>
<select class="form-control input-sm js-select data-select" data-toggle="tooltip" data-placement="bottom" data-trigger="manual" name="std2" id="std2">
<option value="" selected=""> Please Select One: </option>
<option value="Patient"> Patient </option>
<option value="Caregiver"> Caregiver </option>
<option value="Advocate"> Advocate </option>
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OVERVIEW Title: Medical Cannabis Treatment Options for Seizure Disorders Duration: 1 hour, 30 minutes Available On Demand Register Now Already Registered? Business Email* First Name* Last Name* Title* Company Name* Street Address 1* Street Address 2 City* State/Province* Please Select One Non-US Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming AA AE AP American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Virgin Islands Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Postal Code* Country* Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ashmore and Cartier Islands Australia Austria Azerbaijan Bahamas, The Bahrain Baker Island Bangladesh Barbados Bassas da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Congo, Democratic Republic of Cook Islands Costa Rica Cote d'Ivoire Croatia Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europa Island Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern and Antarctic Gabon Gambia, The Gaza Strip Georgia Germany Ghana Gibraltar Glorioso Islands Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Holy See (Vatican City) Honduras Hong Kong Howland Island Hungary Iceland India Indonesia Iraq Ireland Israel Italy Jamaica Jan Mayen Japan Jarvis Island Jersey Johnston Atoll Jordan Juan de Nova Island Kazakhstan Kenya Kingman Reef Kiribati Korea, South Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Man, Isle of Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Midway Islands Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Navassa Island Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palmyra Atoll Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Saint Vincent and Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia South Sudan Spain Spratly Islands Sri Lanka Suriname Svalbard Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tromelin Island Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wake Atoll Wallis and Futuna West Bank Western Sahara Yemen Zambia Zimbabwe Business Phone What best describes your business/industry? Please Select One: Analytical Testing Labs/Contract Laboratory Consulting University Cultivation/Grow Facility Dispensary Medical/Clinical Lab Government Manufacturing/Processing/Extraction Other What is your status/role? Please Select One: Patient Caregiver Advocate Healthcare Professional Other If you selected Other, please specify If a healthcare professional, please indicate your profession: Please Select One: Physician Pharmacist Nurse Other healthcare professional If you selected other healthcare professional, please specify: Yes, I would like to receive a free subscription to Cannabis Patient Care magazine By registering for this event, you agree toMJH Life Sciences ® Terms and Conditions, PrivacyPolicy, and understand your data will be used byMJH and its affiliates for amongst other things, alerting you to other servicesor products that you maybe interested in, and may be shared with or sold tothird parties for their use, including possible contact with you through emailor other communications, consistent with their respective privacy policy. Ifyou do not agree to have your data used in this way, please contact info@mjhassoc.com. Email for Newsletter* Domain Value* *Denotes required. REGISTER Please enable Cookies in your browser before registering for the webcast. You must have Javascript and Cookies enabled to access this webcast. Click here for Help. Summary Available On Demand! -------------------------------------------------------------------------------- Sponsored By: Event Overview: Join Nurse Janna Champagne for a review of the basics of the endocannabinoid system and a discussion on the latest research supporting cannabis for seizures. Nurse Janna’s presentation will be followed by a panel discussion with several medical cannabis patients and caregivers using these treatment options for their seizure disorders. Key Learning Objectives: 1. Participants will be educated on structure and function of endocannabinoid system. 2. Participants will learn about various cannabis components. 3. Participants will discover the research-supported benefits of cannabinoids and terpenes specifically for seizure management. Who Should Attend: Target audience includes patients and medical professionals interested in learning about cannabis for epilepsy and seizure management. -------------------------------------------------------------------------------- For any questions please contact Kelsey Barry: kbarry@mjhlifesciences.com Speakers Janna Champagne, BSN, RN Founder, Cannabis-Specialty Nurse Integrated Holistic Care Nurse Janna's introduction to the cannabis industry began as a cannabis patient--who also happened to be a nurse--when she suffered a debilitating immune health collapse in 2012. Janna credits cannabis for helping to reduce her reliance on harmful pharmaceuticals, and supporting her ability to regain her health including reversal of autoimmune disease, against all odds. Janna is also known for her success in treating her daughter's Autism with cannabis. This became the cover story in a national cannabis industry magazine in 2017. www.integratedholisticcare.com/news Nurse Janna's focus is holistic treatment--natural alternatives to pharmaceuticals including CBD and cannabis therapy. She has worked as a cannabis-specialty nurse since 2015, and has educated thousands of patients, helping them optimize their cannabis therapy outcomes through an individualized and well-informed approach. Janna has since applied her extensive clinical knowledge to educate medical professionals about cannabis, and help producers create therapeutic quality and targeted cannabis products, with a goal of improving cannabis patient success rates. Janna is also founder of Autism Safe Haven, a 501c3 nonprofit dedicated to improving cannabis-inclusive Autism care resources. Nurse Janna's specialties include: Autism, Inflammatory/Chronic Pain Syndromes, Autoimmune, Neurological, Gastrointestinal, and Mental Health conditions. Janna found that success in cannabis often results in reduced reliance on pharmaceuticals, meanwhile improving quality of life and function. Nurse Deb McCauley, BSN, CRRN C.J. Carter