Application Form – Locals Feedback

Please fill out your information below, and we will reach out soon with instructions. Please don't fill this out more than once!

First Name*

Last Name*

Email*

Phone Number*

Which CITY do you live in?*

Which state do you live in?*

What is your $CashTag?*

I will check my SPAM folder, as email instructions may go there*

I will check my SPAM folder, as email instructions may go there

I consent to the processing of my personal data. (NOTE your information is ONLY used for these surverys, and is not shared with anyone else)*

I consent to the processing of my personal data. NOTE: your information is ONLY used for these surverys, and is not shared with anyone else.