UGC / INFLUENCER Submission

First Name *

Last Name *

Phone Number *

Email *

Are you currently signed with any agency? *

YES, Exclusive

YES, Not Exclusive

If YES, what agency are you signed with? *

Date of Birth (age) *

Height *

Bust/Chest *

Waist *

Hips *

Dress Size *

Hair Color *

Eye Color *

Do you have any piercings? *

Do you have any tattoos? *

Instagram Handle (@) *

Experience/ Additional Info *

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