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* 1. How interested are you in becoming a Benefit Partner with our association?

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* 2. What motivates your interest in becoming a Benefit Partner?

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* 3. Are your products or services available to customers in:

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* 4. Who are your primary customers?

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* 5. What type of benefit would you be willing to offer NATDA members?

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* 6. Are there any limitations or conditions tied to the member discount?

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* 7. Does your product or service include a revenue-share or referral-fee opportunity for NATDA?

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* 8. Company Name

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* 9. Contact Name

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* 11. Company Website

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* 12. Phone Number

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