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* 1. Are you interested in being a guest speaker at an upcoming BWAZ virtual event?

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* 2. What type of topics are you interested in sharing with the BWAZ online platform?

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* 3. Are you comfortable with being on camera?

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* 4. These virtual events will typically take place on the weekends.
Are you available on the weekends to film?

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* 5. This opportunity is currently only available for women residing in Arizona.
What city do you live in?

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* 6. What is your email address?

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* 7. What is your first and last name?

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* 8. Do you have a website?

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* 9. What are your social media handles?
(Facebook, Instagram, & Twitter)

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* 10. Do you have any additional that information you would like for us to know?

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