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National Moms Nite Out
1.
Email address:
2.
How often do you have a night out with friends only?
Once a week
Once a month
Twice a year
Never
3.
What is your favorite activity when you're having a night out away from your family?
Going to the mall, and shopping with girlfriends.
Hosting or attending an in-home party.
Having dinner and drinks at your favorite local hot spot.
Going to the movies to catch a chick-flick.
Volunteering or doing something charitable
Karaoke
Just being by myself and doing something I enjoy
Other (please specify)
4.
How deserving do you feel you are of a Mom's night out?
Extremely deserving
Somewhat deserving
Not deserving
5.
What tasks as a mom earns you a Mom's night out?
6.
Who would you like to spend Mom’s night out with?
My best friend.
A group of friends.
Meeting new people.
Just enjoy some alone time.
Other (please specify)
7.
What is the one thing you most worry about when it's Mom's night out?
Spouse will let the kids stay up too late.
The kids won’t get dinner.
Dad falling asleep before the kids.
Incomplete homework.
Other (please specify)
8.
Does your spouse or partner have a regular night out?
Yes
No
9.
What's your favorite color to wear on Mom's night out?
Black
White
Red
Blue
Pink
Other (please specify)
10.
Describe your style on Mom's night out?
Jeans, T-shirt/Tank Top
Mini-dress and heels
Other (please specify)
11.
Updo or ponytail?
Letting my hair down/natural
Updo
Ponytail
12.
What keeps you from dedicating a night only for yourself?
Busy work schedule
Lack of childcare
Not enough fun options
No time to get away from family
Lack of money
Someone to do something with
Other (please specify)
13.
How do you feel when you're away from home?
Guilty
Relaxed
Nervous
Blissful
Victorious, the sense of acomplishment for earning a nite off
14.
As a mom, what is the service you’d most like to receive to escape from your daily routine?
Manicure and pedicure
Style consultation
Massage
Yoga instruction
Other (please specify)
15.
Where do you go to escape your daily routines?
Mall
Spa
Park
Restaurant
Other (please specify)
16.
Do moms deserve a night out alone?
No – children and family should be moms’ priority
Yes – moms need more easy options for getting away
17.
On Mother's Day, how much time do you devote to the other mothers in your family's life? ( i.e. Your mother, grandmothers, mother in laws)
A few hours
The entire day
None
Other (please specify)
18.
How many other mother's do you celebrate with your family on or around Mother's Day? ( i.e. Mothers, grandmothers, in-laws)
1
2
3
4
5
More than 5
Other (please specify)
19.
What celebrity guy would you most like to have accompany you and your friends during a night out?
Ryan Gosling
Denzel Washington
George Clooney
Jay-Z
Ryan Reynolds
Marc Anthony
Will Smith
Ashton Kutcher
Pitbull
Bradley Cooper
Simon Cowell
Lenny Kravitz
Matthew McConaughey
Other (please specify)
20.
What celebrity actress/performer would you most like to have join you and your girlfriends during a night out?
Jennifer Lopez
Reese Witherspoon
Jennifer Hudson
Jennifer Aniston
Eva Longoria
Halle Barry
Sandra Bullock
Beyonce
Betty White
Viola Davis
Angelina Jolie
Jennifer Garner
Other (please specify)
21.
In one sentence, describe your funniest parenting challenge or “fail”?
Forgetting it was my child’s picture day at school.
Rushing my child off to the bus stop on a Saturday.
Not arranging for someone to pick my child up from an after-school activity.
Forgetting to send my child to school with lunch.
Other (please specify)
22.
What activities, if any, would you prefer to do if you could spend less time at home?
Spend time with girlfriends
Go shopping
Exercise
Go dancing
Other (please specify)
23.
From a mom’s perspective, which of the following, if any, would you be willing to give up for one year in order to have a night out with friends once a week?
Cell phone
Internet
TV
Favorite snack
Several nights of solid sleep
Other (please specify)
24.
National Mom's Nite Out is Thursday, May 10th. How do you think you'll be celebrating your special night out?
Celebrating at a local Mom's Nite Out Simon Mall event, and shopping with girlfriends.
Hosting or attending an in-home party.
Having dinner and drinks at your favorite local hot spot.
Going to the movies to catch a chick-flick.
Volunteering or doing something charitable
Karaoke
Other (please specify)
