About You! www.jolique.com

In order to make our website the best it can be for you, we need to know who you are. Please take 5 minutes to fill out this survey. Thanks!

Who Are You ?
First Name:
Last Name:
Street Address 1:
Street Address 2:
City:
State/Province:
Country:
Zip Code:
E-Mail Address:
How Old/Young Are You?
1) Brimming with Youth (17 and under):
2) Old Enough to Know Better (18 - 24):
3) Clinging to Your Youth (25 - 29):
4) In Your Prime (30 - 39):
5) Older and Wiser? (40 and above):
Sex/Gender Orientation
1) Female/Feminine:
2) Male/Masculine:
3) Transsexual/Transgender:
What Do You Do? (list employment or area of study)
How Hard Did You Study? (please select highest degree of completed education so far)
1) Middle or high school:
2) High school diploma:
3) Two-year college degree:
4) Four-year college degree:
5) Graduate degree:
How Much $ Do You Make?
1) Grossly underpaid for my talents ($25,000/year or less):
2) Talent still undervalued, but at least no longer need food stamps ($25,001 to $50,000/year):
3) On my way--can afford regular pedicure, aromatherapy or similar ($50,001 to $100,000/year):
4) On top of the world--am complete genius ($100,001/year or above):
How Fast Are You? (please select your modem connection/speed):
How Did You Hear About Jolique?
1) Search engine (enter name):
2) Print or Internet magazine/newspaper (enter name):
3) Link from another site (other than search engine):
4) Recommendation from friend, family member or co-worker:
5) Other (please specify):
How Can We Make Our Site Better?