First Name

Last Name

Email *

Phone *

Address

City

State

Postal code

Legal Business Name

Business Registration Number (EIN)

Magazine #1 Name

Magazine #2 Name

Magazine #3 Name

Magazine Website URL (If you have one.)

Magazine Town / Metro Area (Your area should be hyper-targeted like a town vs. a city or county.)

BVM Email Signature

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NOTE: Please email your headshot, logos, magazine covers, email signature graphics and/or other graphics that apply to: [email protected]