INFLUENCER PARTNERSHIP apply as influencer representative INFLUENCER APPLICATION REPRESENTATIVE APPLICATION Your contact information * are required First Name * Last Name * City/State Format: Seattle, WA Profession/Occupation * Age * Email * Phone Format: XXX-XXX-XXXX Who do you work for? Your social / web information INSTAGRAM HANDLE # OF INSTAGRAM FOLLOWERS TWITTER HANDLE # OF TWITTER FOLLOWERS FACEBOOK HANDLE # OF FACEBOOK FOLLOWERS YOUTUBE HANDLE # OF YOUTUBE FOLLOWERS WEBSITE ADDRESS WEBSITE TRAFFIC (# USERS/MONTH) More about you WE CELEBRATE OVERACHIEVERS WHO GO ABOVE AND BEYOND TO BE THE BEST VERSIONS OF THEMSELVES. WHAT SETS YOU APART FROM THE PACK? ARE YOU AFFILIATED WITH ANY CHARITIES OR NATION / LOCAL ORGANIZATIONS? IF SO, WHAT ARE THEY AND WHAT IS YOUR ROLE? HAVE YOU EVER PROMOTED ANOTHER WATER OR BEVERAGE BRAND? IF SO, WHAT BRANDS? DO YOU OFFICIALLY WORK WITH OR REPRESENT ANY OTHER BRANDS? PLEASE LIST THEM. WHY DO YOU WANT TO PARTNER WITH ESSENTIA WATER? * IS THERE ANY ADDITIONAL INFORMATION YOU WANT US TO KNOW? PLEASE ENTER ANY TWO DIGITS. * SUBMIT APPLICATION IT MIGHT AS WELL BE YOU This is a call to get up, get out and go do that thing you really really want to do. SEE OUR CAMPAIGN FIND A STORE NEAR YOU SEARCH KEEP UP WITH ESSENTIA ESSENTIA WATER, LLC. 18911 North Creek Parkway, Ste. 150, Bothell, WA 98011 425.402.9555 Or toll free: 877.293.2239 customerservice@devessent.livewebtesting.net