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* 1. Please provide us with your contact information.

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* 2. Have you completed Erica's Prenatal Exercise Specialist Instructor Certification?

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* 3. Are you currently an Elite VIP Member?

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* 4. Which of Erica's programs have you have joined or purchased? Please select all that apply.

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* 5. Why do you want to be a Brand Ambassador for Erica Ziel?

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* 6. What is one way in which you feel you could help promote one or more of Erica's programs or products?

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* 7. Please tell us a little bit about you and anything else you would like us to know!

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