Name *

First Name

Last Name

Rate your Personal Style *

Be honest..it would help us..

Excellent

Good

Fair

Below Average

Rate your Fashion Awareness *

Don't be shy..we shall help you here too..

Excellent

Good

Fair

Below Average

Rate your over-all image - at work, with friends & at home *

Excellent

Good

Fair

Below Average

Date

MM

DD

YYYY

Phone

(###)

###

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Name *

First Name

Last Name

What do you want to achieve from our advisory and consultations?(Check all that apply) *

A more professional image

Greater confidence for personal satisfaction

Want to look younger/slimmer

How to put together wardrobe to save time

Want to blend with the crowd in abroad easily

Other

In which areas do you feel you need advice? (Check all that apply) *

Dressing and Grooming

Styling

Hair/makeup

Clothing selection

Organizing Wardrobe

Layering & Accessorizing

Verbal Communication

Non-Verbal Communication

Appearing in the media

Dining etiquette

Business etiquette

Other

Date

MM

DD

YYYY

Phone *

(###)

###

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