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    Your Name:

    Do you have a Website?*

    [group have-website]

    What is your website URL?* (e.g., www.mediamarkspotlight.com)

    [/group]

    Do you have Social Media accounts?*

    [group have-social]

    What is your social media handle/handles?* (e.g., facebook.com/mediamarkspotlight)

    [/group]

    What is your preferred contact method?*

    [group Text]

    What is your Phone Number?*

    [/group]

    [group Email]

    What is your Email Address*

    [/group]

    [group phone]

    What is your Phone Number?*

    [/group]