Holistic Network Member Information

Please answer the questions below to participate in the Holistic Network of Tampa Bay's quarterly email communication.

Your Full Name:

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* 1. Your Full Name:

Your email address:

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* 2. Your email address:

List 2 holistic health topics you would like to write about...

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* 3. List 2 holistic health topics you would like to write about...

Number of email subscribers (enter 0 if you do not have an email list)

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* 4. Number of email subscribers (enter 0 if you do not have an email list)

Number of Social Media followers (enter 0 if you do not have a social media presence)

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* 5. Number of Social Media followers (enter 0 if you do not have a social media presence)

What special or discount would you like to offer to consumers? (i.e. free initial consult, 25% off first visit/purchase, etc.)

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* 6. What special or discount would you like to offer to consumers? (i.e. free initial consult, 25% off first visit/purchase, etc.)

Number of monthly website visitors (enter 0 if you do not have a website)

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* 7. Number of monthly website visitors (enter 0 if you do not have a website)

Number of times per year you post to a blog (enter 0 if you do not blog)

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* 8. Number of times per year you post to a blog (enter 0 if you do not blog)

What theme(s) would you like to see for the first quarterly communication?

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* 9. What theme(s) would you like to see for the first quarterly communication?

What questions or comments do you have about this opportunity?

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* 10. What questions or comments do you have about this opportunity?

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