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| Personal Shopping Questionnaire |
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| Personal |
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| Name: |
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_____________________________________ |
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| Birth Date: |
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_____________________________________ |
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| Address: |
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_____________________________________ |
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| City/State/Zip: |
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_____________________________________ |
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| Country, if applicable: |
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_____________________________________ |
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| Home Phone: |
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_____________________________________ |
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| Cell Phone: |
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_____________________________________ |
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| Email: |
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_____________________________________ |
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| Best way & times to contact you: |
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_____________________________________ |
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| Career/job title/company: |
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_____________________________________ |
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| Marital Status: |
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_________________ If children, ages: ___________ |
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Body |
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| Height: |
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_________________ Weight: ______________ lbs |
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| Hair color: |
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_______________ |
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| Hair style: |
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| ______ ear length |
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______ shoulder length |
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| ______ below shoulder |
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______ thick |
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| ______ fine |
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______ straight |
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| ______ curly |
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______ wavy |
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| Eyecolor: |
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____________________ Glasses: __ yes __ no |
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| Skin color: |
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| ______ ivory |
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______ pink |
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| ______ reddish |
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______ olive |
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| ______ yellow |
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______ light brown |
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| ______ dark brown |
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| Dimensions: |
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(ask a friend to measure circumferences of the body to the closest 1/4" using a tape) |
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| shoulder across front |
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_______________ |
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| shoulder across back |
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_______________ |
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| (from shoulder bone to wrist bone) |
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| Describe any fit problems: |
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________________________________________ |
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| Body type: |
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| ______ pyramid |
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______ inverted pyramid |
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| ______ hourglass |
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______ rectangle |
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| ______ round |
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Image |
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| Your style descriptor: |
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| ______ classic/elegant |
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______ classic/business |
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| ______ cutting edge |
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______ folk/country |
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| ______ classic/casual |
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| ______ other, describe |
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__________________ |
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| Which well-known woma(e)n's style do you most identify? Why?: |
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__________________ |
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_________________________________________ |
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| Which designers (brands) do you like? Why?: |
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__________________ |
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_________________________________________ |
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| Which stores do you most shop? Why?: |
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__________________ |
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_________________________________________ |
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| Which colors do you most wear?: |
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__________________ |
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_________________________________________ |
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Shopping/Wardrobe |
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| List what you least like about shopping: |
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_________________________________________ |
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| List what you most like about shopping: |
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| Prioritize the four most important characteristics you want in |
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| your wardrobe, 1 being most important and 4, least important : |
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| ______ fit |
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______ comfort |
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| ______ reasonable cost |
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______ image |
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| ______ ease in travel |
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______ style |
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| ______ versatility |
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______ wide selection |
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| ______ other |
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__________________ |
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| Have you ever used a personal shopper before? Describe: |
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_________________________________________ |
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_________________________________________ |
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| Your shopping list for this season: (please note desired item. |
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| color & fabric, star the most important) |
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| career |
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_______________________ |
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_______________________ |
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| week-end casual |
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_______________________ |
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_______________________ |
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| week-end elegant |
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_______________________ |
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_______________________ |
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| special occasion |
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_______________________ |
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_______________________ |
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| other |
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_______________________ |
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_______________________ |
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| What is your total budget for these items?: |
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__________________ |
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| Suggested shopping dates and neighborhoods/stores |
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| you would like to shop: |
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_________________________________________ |
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_________________________________________ |
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| Signature: |
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____________________________________________________ |
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Date: |
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To reserve your shopping session with Susan, please mail completed questionnaire with deposit check to: Susan Dresner, 36 West 89th Street, 4A New York, NY 10024.
Any questions, call Susan 212-877-1417 between 8 am - 6 pm EST, M-F. |
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