1.What is your first name?

2.What is your last name?

3.your phone number with area code

4.your age category

18-24

25-34

35-44

45-54

55-64

*5.Which of the following activities are you interested in participating in online LIVE within a women's virtual club? Select all that apply.(Required.)

Group coaching to share experience and relief stress (fears, overthinking, negative thoughts, assumptions,..)

Workshops for building skills (leadership, communication,..)

Workshops to Increase awareness about emotions (presentations style)

Practicing hobbies in a group (book club, art club,..)

Socializing and networking

Business Forum

Other (Please specify in the next question)

*6.If you selected 'Other' in the previous question, please specify which other activities you would be interested in.(Required.)

*7.The Club activities will take place once a week, each for 1-2 hrs Live. Are you willing to commit attending a minimum of 5 days per week?(Required.)

Yes, I will commit; this is great opportunity to spend some time for myself

No, this is too much for me

I will try to attend live, otherwise i will see the recordings

Other: None represents me, I want to write a suggestion

8.write your suggestion here, if any

*9.What time of day would you prefer these activities to take place?(Required.)

Morning

Afternoon

Evening

No preference

10.Do you prefer to pay the membership on which basis:

Monthly

Twice annually

Quarterly

Annually