Thank you for your interest in Mom TV. We are excited to have your input which will help us meet your goals when it comes to videos online.

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* 1. Please provide the following information:

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* 2. Which MomTV opportunities interest you? Please select all that apply.

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* 3. If you are open to hosting a live show, how often would you like your show to be live?

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* 4. Please list your:

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* 5. How often are you currently creating new videos?

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* 6. Please select the type(s) of content you enjoy producing

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* 7. Do you currently feature videos on your blog/website?

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* 8. Do you currently store your videos on Youtube?

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* 9. Which of the following services provided by MomTV do you feel will help you grow most in the world of online video?

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* 10. Additional Comments (Optional)

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