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* 1. First Name

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* 2. Last Name

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* 3. What is your preferred email address?

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* 4. Which social media platforms are you active on?

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* 5. Please include your social handles here

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* 6. What type of content do you create for your audience?

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* 7. Where are you located?

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* 8. I agree to Vosges Haut-Chocolat enrolling me in the Captiv8 platform in order to participate in their Ambassador Program

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