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* 1. Full Name

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* 2. What country do you live in?

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* 3. Are you over 18 years old?

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* 4. E-mail 

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* 5. Links Social Media Accounts

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* 6. Follower count on each social account

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* 7. Links to past audiobook reviews on qualifying social accounts (not Goodreads)

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* 8. Are you a current PRH Audio influencer?

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* 9. Do you have an account on Influencers@PRH?

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* 10. Do you have an account in the PRH Audio app?

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* 11. Is their a different name or email that you're currently using for the app or Influencer@PRH?

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* 12. Any comments?

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