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* 1. Delegate Name

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* 2. Delegate Mobile/Cell Number

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* 3. What is your Skype profile name and/or Google email address?

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* 4. What is your city location?

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* 5. Business Name

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* 6. Business Email Address

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* 7. Business Website

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* 8. What are your business services?

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* 9. Describe your clients / target audience

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* 10. What type of business industry do you want to network and connect with on September 22nd (can select more than one industry)

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