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Chick Media Network Application

Name *This question is required.
Address *This question is required.
This question requires a valid email address.
Preferred Contact Method *This question is required.
calendar
Gender *This question is required.
Ethnic Background *This question is required.
Education *This question is required.
Do you have children? *This question is required.
This question requires a valid number format.
Children's Age Range (select all that apply)
Employment Status *This question is required.
1. How do you measure your metrics?
Other Blogs or Websites
Do you review products? *This question is required.
Do you vlog (video blog)? *This question is required.
Media Kit Upload
This question requires a valid number format.
Secondary Twitter URL
This question requires a valid number format.
Other Social Networking/ Community Participation
Do you currently monetize your site? *This question is required.
How?
Are you interested in generating Ad Revenue from your site? *This question is required.
Program Interests *This question is required.
Areas of Interests *This question is required.
In addition to joining Chick Media Network, and receiving notifications about opportunities from us and our partners, would you like to receive additional correspondence from us? *This question is required.*We protect your email, contact and personal information– and under no circumstances distribute them without prior consent.
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Glam Mommy Media, LLC