Form to request a discount code for participants located in the global south.

Survey deadline reached.
Name: *(Up to 100 Words)
Email:*
Confirm Email:*
Country:*
State/Province/Region
Please share below your role and affiliated organization if applicable.(Up to 200 Words)
Are you currently located in the country selected above:*
I hereby confirm that I have completed the form accurately and truthfully.*
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