Near East In-Home Party Registration
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1. Near East Registration
If you are interested in receiving a Near East in-home party kit and hosting an event, please register here. Limited quantities are available.
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1
. First Name
First Name
*
2
. Last Name
Last Name
*
3
. Email Address
Email Address
*
4
. Street Address
Street Address
*
5
. City
City
*
6
. State
State
*
7
. Zip
Zip
*
8
. Phone Number
Phone Number
9
. We are looking for parties to be held between April 19, 2010 and August 15, 2010. What is the potential date for your event?
We are looking for parties to be held between April 19, 2010 and August 15, 2010. What is the potential date for your event?
10
. What age range do you fall into?
What age range do you fall into?
25-34
35-44
45-54
55+
11
. What is your employment status?
What is your employment status?
Full-time
Part-time
Unemployed
12
. Do you have children in the home?
Do you have children in the home?
Yes
No
13
. On a 1-10 scale, where “1” means “strongly disagree” and “10” means “strongly agree,” how much do you agree with the following statement?
I am very proactive about my health and regularly look for health information.
On a 1-10 scale, where “1” means “strongly disagree” and “10” means “strongly agree,” how much do you agree with the following statement? I am very proactive about my health and regularly look for health information.
1
2
3
4
5
6
7
8
9
10
14
. What are your biggest challenges in cooking dinner? Please select all that apply.
What are your biggest challenges in cooking dinner? Please select all that apply.
Time to plan and prepare meals
Deciding what to make
Choosing healthy options
Making meals that taste great
Satisfying picky eaters
15
. Are you open to trying to prepare new foods you haven’t tried to make before, in order to spice up your repertoire of go-to meals?
Are you open to trying to prepare new foods you haven’t tried to make before, in order to spice up your repertoire of go-to meals?
Yes, always open to trying to make new things
Maybe; it sounds good in theory, but then when it comes down do it, I don’t usually go to the trouble to learn something new
Not really; I’m happy with the meals I usually prepare
16
. How many times per week do you cook dinner using the stove or oven (not microwave oven)?
How many times per week do you cook dinner using the stove or oven (not microwave oven)?
1-2
3-4
5-6
7 or more
17
. Which of the following social networks do you interact with regularly? Please select all that apply.
Which of the following social networks do you interact with regularly? Please select all that apply.
Facebook
Twitter
LinkedIn
MySpace
Flickr
Your personal blog
None of the above
18
. Do you belong to any groups or organizations? (i.e. networking groups, professional groups, sports leagues, book clubs, social groups, etc)
Do you belong to any groups or organizations? (i.e. networking groups, professional groups, sports leagues, book clubs, social groups, etc)
Yes
No
19
. If so, how many groups would you say you belong to?
If so, how many groups would you say you belong to?
1-2
3-5
6-8
8+
20
. Have you ever hosted an in-home party before?
Have you ever hosted an in-home party before?
Yes
No
21
. Who would you invite to your in-home party? Please select all that apply.
Who would you invite to your in-home party? Please select all that apply.
Close friends
Colleagues
Neighbors
Family members
Acquaintances
22
. Do you ever share cooking tips, recipes or interesting information you find online with your friends and family?
Do you ever share cooking tips, recipes or interesting information you find online with your friends and family?
Yes
No
23
. Please tell us why you’re interested in hosting an in-home party on behalf of Near East:
Please tell us why you’re interested in hosting an in-home party on behalf of Near East:
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