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Home
My Story
Style Blog
Packages
Questionnaire
Free Advice
Free Men's Advice
Features
Partners
Services Questionnaire
Basic Information:
Name
*
First Name
Last Name
Email Address
*
Phone Number
(###)
###
####
Current relationship status:
*
Single
In a relationship
Engaged
Married
Separated
Divorced
Widowed
Select your age group:
*
>24
25-34
35-44
45-54
55-64
65+
Additional Information:
How would you describe your lifestyle?
*
Busy/Active
Balanced
Relaxed
Other
Select "Other"? Place your response here.
What is your occupation?
*
Business Professional
Medical Professional
Self-Employed
Creative Professional
Home-maker
Financially Independent
Which describes your current style best?
*
Classic
Casual/Comfortable/Athletic
Romantic/Bohemian
Bold/Daring
Creative/Eclectic
Other
Select "Other"? Place your response here.
Which describes your aspired style best?
*
Classic
Casual/Comfortable/Athletic
Romantic/Bohemian
Bold/Daring
Creative/Eclectic
Other
Select "Other"? Place your response here.
What body shape best describes you?
*
Apple / Inverted Triangle
Pear / Triangle
Hourglass
Ruler /Straight
I do not know
Who (or what) is your style inspiration?
*
Personal Information:
What are your primary concerns in regards to working with an image consultant?
*
1. Financial Investment
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
2. Time Investment
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
3. Personal Commitment
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
4. Comfort Level (Personal Privacy)
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
How did you hear about Andrea Bonawitz Image Consulting?
*
Facebook
Search Engine (Google, Bing, Yahoo, etc.)
Other Social Networks (Instagram, Twitter, Periscope, YouTube, etc.)
Local Advertisement
Friend or Family Member
Event
Forum or Blog
I am a current Parlour client.
You contacted me!
Other
Select "Other"? Place your response here.
Thank you!