IMPACTR ACTIVATOR SIGNUP FORM

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Email *

First Name *

Last Name *

Location (Country) *

Why would you like to become an Activator for IMPACTR? *

Please provide a relevant link to your website or a preferred social profile? (NB: Used to review your Activator registration) *

How did you hear about IMPACTR? If someone referred you, kindly include their name.

Disclaimer *

By ticking this box you consent to our privacy policy and terms & conditions: Visit https://www.impactrs.global/privacy-policy and https://www.impactrs.global/terms-conditions.

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A copy of your responses will be emailed to the address you provided.

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