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Put a cool background image as this row background that goes with your brand!
Feel free to message and get the answers to your all your questions!
Create a form through your email marketing platform (like MailChimp or ActiveCampaign) or if you haven't got anything like that set up yet, create a Wufoo form or form on a similar platform that will collect answers for you.
Insert it here using the 'Custom HTML' element with the link provided to you.