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Full Name
Address
Phone Number
How much have you invested in yourself or your business in the last 12 months?
Describe your business/company for me...
What is a challenge for you in your business? Check all that apply:
If you could wave a magic wand and change three things in your business and life in the next 12 months, what would they be?
Understanding this is a rare opportunity with only 25 women being chosen not everyone will be chosen or contacted what else would you like to share with us on why we should select you?
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