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1
Name
First Name
Last Name
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2
Social Media Handles
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3
Email
example@example.com
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4
Phone Number
Please enter a valid phone number.
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5
What type of June Karter education are you interested in?
Shadow Day Experience
Extension Course + Mentorship
1:1 Coaching
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6
What are you hoping to receive from this education opportunity?
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7
How much are you willing to invest in June Karter Education
$500-750
$750-$1000
$1000-1500
$1500-2000
$2000+
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8
When are you hoping to start this education?
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Date
Year
Month
Day
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9
Any other info you would like to provide
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