Personal Style Service Application

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1. Your Name* This field is required.
First Name
Last Name
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2. Gender* This field is required.
Male
Female
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3. Email* This field is required.
example@example.com
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Phone Number* This field is required.
Please enter a valid phone number.
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3. Date of Birth* This field is required.
Date
Month
Day
Year
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Current City, State* This field is required.
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4. Ethnicity* This field is required.
Please Select
Please Select
American Indian or Alaska Native
Asian or Asian American
Black or African American
Hispanic or Latino
Middle Eastern
Multiracial
Native Hawaiian / Other Pacific Islander
White or Caucasian
Prefer not to answer
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What is Your Line of Work?* This field is required.
Please Select
Please Select
Advertising & Marketing
Aerospace & Defense
Agriculture & Mining
Arts, Entertainment & Recreation
Automotive
Biotech & Pharmaceutical
Business Services
Construction
Consumer Products
Energy & Utilities
Financial Services
Food & Beverage
Healthcare
Information Communication Technology
Insurance
Professional & Technical Services
Retail
Technology
Transportation & Logistics
Travel & Hospitality
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Are you currently working with an image consultant or personal stylist? (not including personal shopper)* This field is required.
Yes
No
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Have you ever worked with an image consultant or stylist? (This does not include a personal shopper)* This field is required.
Yes
No
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If yes, what services did you receive, what was done well and what was done poorly?
If you selected YES in the previous question, please complete this question. If missed this may cause a delay in your services.
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What obstacles do you feel could be holding you back from being and wearing your best? Where would you like to see your personal appearance in 3-6 months?* This field is required.
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How important is improving your personal style & fashion system right now? On a scale from 1-10 * This field is required.
(1 being 'Not Important at All' and 10 being 'Extremely Important')
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What is your attitude toward your current image?* This field is required.
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Which one sounds like you?* This field is required.
Please Select
Please Select
I like to wear & know the latest fashion trends
I enjoy looking at fashion trends but I'm more comfortable dressing conservative
I can care less about the trends, I want to dress based on what’s going on in my life.
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Right now, my personal style and clothing selections have been..* This field is required.
Conventional (not flashy, fully covered and long lasting wear)
In-between (based of majority of my time, I wear conservative clothes and transition to the latest fashion for side gigs or going out)
Unconventional (you have flexibility in what I wear and enjoy showing being creative with my appearance)
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It always takes me...* This field is required.
Please Select
Please Select
1-2 hours JUST to find something to wear
3+ hours to find or decide what I'm going to wear
I just throw anything on and its time for a change
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When you go shopping for clothes or fashion accessories, you usually buy it because..* This field is required.
You have a new event/occasion so you buy a brand new outfit for it.
You saw this look or item advertised and want to improve yourself but things never work out for you.
You have limited time to thoroughly look for what’s best for you, so you grab one item and try to make it work with something in your closet.
You see a sale while you’re out shopping for something else and you come out the store with more than you expected.
You see a huge sale or clearance rack and that’s the only time you buy clothes.
You loved how it looked on someone or a mannequin and bought the entire outfit.
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What is your body shape?* This field is required.
Please Select
Please Select
I have no idea, never been professionally measured for it.
Inverted triangle
Triangle
Round
Hourglass
Rectangle
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Upload an image of yourself. This image must be you alone.* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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When would you like to start personal styling services?* This field is required.
Please Select
Please Select
This Month
In the next 3-6 Months
Not interested in professional styling services
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If someone advised you to spend a four-figure investment on yourself, you would...* This field is required.
Please Select
Please Select
Invest in yourself. You know exactly what you need to elevate your life, you are seeking help for it.
Be a little hesitate but with a proven system , you would do it because you know you're serious about adding value to your life
Avoid it at all costs because you know you want to do things as cheaply as possible.
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Which MIIEN Consultancy service would you be more interested in?* This field is required.
Please Select
Please Select
Style Photoshoot [ $2,000+ / Half day or Full day]
Closet audit and organizer [ $5,000+]
Makeover & Transformation Program [$30,000+]
Speaker request for Mikara Reid [$8,000+ per topic]
Dressing Audit & Implementation Plan [$800]
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Why do you think Certified Image Consultant/Personal Stylist Mikara Reid is the right style professional for you?* This field is required.
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How did you hear about us?* This field is required.
Please Select
Please Select
MIIEN Website
Google
YouTube
Pinterest
LinkedIn
Instagram
Facebook
Event
Word of Mouth
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