What is your full name?
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What is your preferred email address?
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What is your phone number?
You agree to receive messages from Melissa?
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Yes
No
What is your business website?
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What is the URL of your Personal Facebook profile? (We want to add you as a friend and say hello!)
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Tell me about your current business (revenue generated, offers, etc)
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Monthly Revenue (generated by your business)
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Tell me about your business goals (revenue, working hours, etc)
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What is the size of your email list or audience?
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Is there anything else you'd like us to know as we review your application?
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Submit