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* 1. Business Name

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* 2. Position at Business?

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* 3. Your Name:

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* 4. Contact Information

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* 5. What is the best way to reach you?

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* 6. Type of Business:

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* 7. Years you have been in business:

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* 8. Social Media information

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* 9. Most Convenient Day and Time to Meet:

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* 10. I will volunteer to help the Association by:    (Check all that apply)

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