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Age

Are you a mom?

          Yes     No 

How many kids do you have?

          0     1     2     3     4+ 

Age of Kid(s)

          Under 5     5-10     11-13     14-17     18+ 

Marital Status

          Married     Single     It's Complicated 

Are you a business owner? Please list: Industry, Years in Business, Full/Part-time

Career

Favorite Color

What are you looking forward to most by attending the retreat?

What are your areas of interest?

Which TV mom do you relate to?

Clara Huxtable - The Cosby ShowVivian - The Fresh Prince of Bel AirRainbow Johnson - Black-ishCookie Lyons- EmpireFlorida Evans -Good TimesJulia Baker - Julia

How did you hear about the event?

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