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* 1. Please enter your name.

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* 2. What metals do you prefer? (Click all that apply)

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* 3. Please list any metal allergies.

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* 4. Do you have any preferences or are you adverse to any style of earring backs?

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* 5. List any colors you really like and/or dislike.

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* 6. Based on the above style sheet (link right above survey), list the number of the styles you like and/or dislike.

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* 7. Please provide and additional comments concerning your style preferences.

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* 8. How did you hear about QEC? Did someone refer you?

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* 9. Please also send me monthly updates, insider access to giveaways and sales, plus more! 

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