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* 1. Company Name

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* 2. Company Title

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* 3. Contact Name

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* 4. Contact E-mail

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* 5. Contact Phone

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* 6. Is your company at least 51% owned and controlled by one or more women?

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* 7. Are you a Corporate Member with Women of the Vine & Spirits?

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* 8. Does your company qualify as any of the following classifications?

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* 9. If yes, are you certified through any of the following organizations?

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* 10. How did you hear about Women of the Vine & Spirits?

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