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* 1. Please provide your name, email address and telephone number.

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* 2. Website

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* 3. What is the purpose of this interview?

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* 4. Will Robin be able to talk about her programs and products during the interview, and invite the listeners to register or find more information via a link/website?

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* 5. Is there an affiliate partner opportunity with this interview? (Summit etc)

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* 6. If yes, please provide information about the summit/affiliate opportunity:

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* 7. Please provide at least 3 dates and times that you are available for the interview. (MUST be at least 6 months out)

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* 8. Are you willing to provide a copy of the interview to Robin Chant to syndicate on our social media platforms?

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* 9. What are some examples of your products?

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* 10. What would you like listeners/viewers to take away from this interview?

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