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1
Name
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First Name
Last Name
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2
Are you 18+ years old
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3
Instagram handle and/or phone number
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What Country do you live in?
USA
Canada
UK
Spain
Ireland
Australia
New Zealand
Poland
Lithuania
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5
What are you looking for in this opportunity?
Growing a business
Building my social media
Affiliate opportunity
Would like to know more about each option
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6
Are you currently working or in school?
Working full time
Working part time
In school
Working and school
Not currently working or in school
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7
What are your monthly income goals?
$200-$500
$500-$1000
$1000-$2500
$2500-$5000
$5000+
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8
How would you like me to contact you?
Instagram
Text
Call
Lunch date
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