Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Date
*
-
Month
-
Day
Year
Date
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Who referred you ?
Party
Vendor Event
Other
Name of Party Host or Vendor Group. If not applicable, write “none” Please fill out the name of group , not “you “ I need to know which group for prize drawing purposes
*
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To help me get to know you better, which of these characteristics is most important to you?
*
Relationships, Authenticity, Personal Growth, Significance, Teamwork, Involvement, Community, Charity, Ethics, Harmony, Morality, Contribution Type option 1
Learning, Intelligence, Logic, Self Mastery, Technology, Research and Development, Science, Universal Truths, Expertise, Competence, Accuracy, The Big Picture
Freedom , Flexibility, Spontaneity, Action, Opportunity, Excitement, Attention, Stimulation, Competition, Winning, Fun, Image
Stability, Duty, Rules, Credentials, Titles, Tradition, Systems, Structure, Planning, Processes, Predictability, Responsibility
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I would like to learn more about:
*
Recipes
Cookware
Baking tools and pans
Prep and Kitchen tools
Small Appliances
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Where do you need most help in the kitchen ?
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🙋🏼♀️#mealtimeinspiration Do you get “ stuck in a rut ,” making the same meals over and over, and need to break the cycle?
⏰#convienience Does your busy schedule require quick and easy prep or grab and go meals? Don’t want to spend unnecessary time in front of the stove , that you could be spending time with your family ?
🥘#kitchentools Want to elevate your skills and make everything simpler?
❤️ All of the Above
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Choose the number that matches the numbers next to each Coated Knife
*
1
2
3
4
5
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What is on your Pampered Chef Wish List?
*
I would like to : one
*
Receive emails with promotions and recipes
Texts with promotions and recipes
Host a virtual or Express Parry
Learn more about becoming an Independent Pampered Chef Consultant
None of the above
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