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First Name : 
Last Name : 
Address 1 : 
Address 2 : 
City : 
State : 
Zip : 
Phone : 
Email Address : 
 
 
 
Gender
 
Male
 
Female
 
 
 
Which category below includes your age?
 
17 or younger
 
18-20
 
21-29
 
30-39
 
40-49
 
50-59
 
60 or older
 
 
 
Business Type
 
Retail Store
 
Online Store
 
Boutique
 
Luxury Retail
 
Department Store
 
 
 
Position
 
Director
 
Buyer
 
Manager
 
 
 
Years of experience
 
2-5
 
5 -10
 
10-15
 
15-20
 
20-25
 
25-30
 
 
 
Store Target
 
Men
 
Women
 
Men & Women
 
Children
 
Babies
 
Babies & Children
 
Women & Children
 
Adult & Children
 
 
 
Do you have any Children? If so how many?
Boys
Girls
Grandchildren
 
 
 
How many of those children are 12 and under
Boys
Girls
 
 
 
What's your store target market?