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* 1. Name

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* 2. Current City/State

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* 3. Birth Date

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* 4. Shoe Size

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* 5. Email Address

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* 6. Why are you interested in being a brand ambassador for Lily's Shoes and what value can you add?

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* 7. Are you currently, or have you been a brand ambassador for any other companies?

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* 8. Do you own any of your own businesses?

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* 9. Social Life

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* 10. Social Media Accounts

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