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User ID
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First name
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Last name
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Street Address
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City
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State
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Zip Code
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Email
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Country
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Phone Number
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Website
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Artist Statement
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I consent to you keeping my contact information for internal marketing purposes
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Yes
No
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I'd like to sign up for the newsletter
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Yes, I'll sign up with the link here!
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Would you like your SWAG/print item that comes with membership?
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is not
Yes, I will pick up in-person
Yes, please mail to address provided
No thank you
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Would you like your email to be added to the Art & Tell networking email list?
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Yes, I will contact A2A at the email below!
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