Lumen Media & Influencer Application Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Mailing Address
*
Your Social Media Handle (Put NA if you don't use that channel)
*
How would you describe your follower Avartar?
*
Do You Need A Complimentary Stay at Lumen?
*
Please Select
Yes
No
If Yes to Previous Question, When Would You like to Stay (Weekdays Perferred)?
*
What's the Preferred Acommondation Type (Aframe Tent, Safari Tent, Hygge Cabin, Lykke Cabin)
*
What're the Deliverables for the Stay
*
Do you have any examples of your past work or a media kit?
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