SKOON. Lash and/or Brow Condition User Trial – Application Form

SECTION 1: Personal Details

Question Title

* 1. First Name

Question Title

* 2. Surname

Question Title

* 3. Email Address

Question Title

* 4. Cell Number

Question Title

* 5. Shipping Address

Question Title

* 6. Age Group

Under 20

20–24

25–34

35–44

45–54

55–60

60+

Question Title

* 7. Gender

Female

Male

Prefer not to say

Question Title

* 8. Location (Province)

Eastern Cape

Free State

Gauteng

KwaZulu-Natal

Limpopo

Mpumalanga

North West

Northern Cape

Western Cape

25% of survey complete.