Program Registration Questionnaire

Question Title

* 1. Please leave your contact information for future event notifications.

Name

Email Address

Phone Number

Question Title

* 2. What is your current role or occupation field?

Student

Formulator/Chemist/Engineer

Sales

Educator

Product Development

Consultant

Start Up/ Own Business

Regulatory; Quality; Testing

Packaging

Management / Leadership

Other (please specify)

Question Title

* 3. What market areas are you interested in or currently involved in? (select all that apply)

Skin Care

Hair Care

Make-up

Toiletries

Sun Care

Question Title

* 4. Where are you located?

NJ Area

NY Area

Philadelphia Area

Other (please specify)

Question Title

* 5. What describes you?

Mentor

Mentee

Both

Question Title

* 6. Are you able to commit the necessary time to the mentorship program?

Yes, 1-2 hours a month

Yes, 2-4 hours a month

Question Title

* 7. If you had to describe yourself (select all which apply)

foodie

spontaneous

dog lover

traveler

planner

extrovert

night person

morning person

social butterfly

tech person

cat lover

sports person

health nut

introvert

Question Title

* 8. What do you hope to gain from this program? (select all that apply)

Insight into the industry

How to excel in a career in this industry

Network

Build authentic relationships

Personal growth

Helping Others

Other (please specify)

Question Title

* 9. This program is not designed to teach technical skills, but rather to help build authentic relationships and allow personal growth within the industry. Are you still interested in the program?

Yes

Maybe

Program Registration Questionnaire

Question Title

* 1. Please leave your contact information for future event notifications.

Question Title

* 2. What is your current role or occupation field?

Question Title

* 3. What market areas are you interested in or currently involved in? (select all that apply)

Question Title

* 4. Where are you located?

Question Title

* 5. What describes you?

Question Title

* 6. Are you able to commit the necessary time to the mentorship program?

Question Title

* 7. If you had to describe yourself (select all which apply)

Question Title

* 8. What do you hope to gain from this program? (select all that apply)

Question Title

* 9. This program is not designed to teach technical skills, but rather to help build authentic relationships and allow personal growth within the industry. Are you still interested in the program?

Question Title

* 10. What does the ideal mentor/mentee look like to you?