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First Name
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Last Name
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Your Email
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Short Bio (>70 words)
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Website or Online Portfolio URL
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Primary Role
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Specialties (Check all that apply)
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Recent Awards and Accolades
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How many years have you been active in your industry?
References
Please provide at least 2 references with their 1) Names, 2) Relationships with you, 3) Email Addresses
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