[{"type":"text","label":"Your name","value":"Juan Pablo Corsi"},{"type":"text","label":"Email","value":"jpcorsi@clientesilimitados.cl"},{"type":"text","label":"Full Address","value":"Libertad 269 Vi\u00f1a del Mar Valparaiso Chile"},{"type":"text","label":"Phone Number","value":"+56950189795"},{"type":"text","label":"How will you affiliate?","value":"I have experience as a Google Partner, I can advertise any niche and industry,  I am a member of over 2000 affiliate programs, I will market you through email lists, SEO"}]