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Type of Business (*)
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Years with Company
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Years in Position (*)
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Years in Industry (*)
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Are you involved in any other businesses within the region? (*)
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If yes, please list the name of the company, your position, and the type of business it represents:
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Please list your involvement in other professional groups (*)
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How did you hear about PWR? (*)
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If you were referred to PWR, who referred you?
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What do you hope to gain from PWR?
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Who is your ideal customer?
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How long have you lived in the area? (*)
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Which geographical area(s) do you service? (*)
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