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* 1. Full Name

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* 2. Company

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* 3. Title at Company

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* 4. Years of Experience

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* 5. Technology Sector (i.e. Software, HealthTech, FinTech, etc.)

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* 6. Major Metro Area (i.e. NYC, LA, Boston, Chicago, Dallas, DC, etc.) or State (VT, NH, MD, etc. )

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