Holistic Network Member Information

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

* 1. Your Full Name:

* 2. Your email address:

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

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

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

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

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

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

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

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