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Questions marked with an asterisk (*) are mandatory.
Thank you for your interest in becoming a Moms Meet Mom Ambassador! Our Mom Ambassadors are selected based on a number of criteria. Please take your time to answer the following questions and determine whether the Mom Ambassador program is right for you. The survey should take 8-10 minutes to complete.
Rest assured that all information you provide will be kept in strict confidence. We do not share your information with any third party.
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* What is your name and contact information?
Note: The Mom Ambassador program is currently available in the United States only. If you reside outside the United States and would be interested in participating, please email us at momambassadors@greenmomsmeet.com.
Mailing address must be a physical address and not a PO box.
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2
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* How did you hear about Moms Meet?
| Kiwimagonline.com |
| Web search |
| Another Mom Ambassador |
| Friend |
| Relative |
| Facebook |
| Twitter |
| Someone reached out to me through Meetup.com |
| Website or blog |
| Other, please specify |
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3
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If you heard about Moms Meet through a website or blog, please specify the name and/or URL.
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4
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* What is your age?
| Under 18 |
| 19-24 |
| 25-29 |
| 30-34 |
| 35-39 |
| 40-44 |
| 45-49 |
| 50-54 |
| 55-59 |
| 60 or over |
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5
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* Are you employed?
| Yes, I work full-time outside of the home. |
| Yes, I work part-time outside of the home. |
| Yes, I work from home. |
| I am not employed. |
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6
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* What is your level of education?
| High school degree |
| Completed some college |
| College degree |
| Graduate or professional degree |
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7
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* What is your annual household income?
| Less than $40,000 |
| $41,000 to $75,00 |
| $75,001 to $99,99 |
| $100,000 to $150,00 |
| $150,001 to $250,00 |
| $250,001 or more |
| Decline to answer |
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8
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* How many children do you have?
| 1 |
| 2 |
| 3 |
| 4 |
| 5 or more |
| Expecting my first |
| None |
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9
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* What are the ages of your children?
| Newborn |
| 6 - 23 months |
| 2-4 |
| 5-7 |
| 8-10 |
| 11-13 |
| 14-17 |
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10
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* Are you currently pregnant or planning to become pregnant in the next year?
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11
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* Do you have any pets?
| Yes, a dog. |
| Yes, a cat. |
| No |
| Yes, other |
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12
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* We'd like to learn more about your interest in and experience with green living. By "green", we mean natural, organic, environmentally and socially responsible living. How would you rate your current involvement with this type of lifestyle?
| I am very involved |
| I am somewhat involved |
| I am not involved but want to be |
| I am not involved and do not want to be |
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13
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* Which, if any, of the following do you currently use?
| Natural, organic, or cloth diapers |
| Natural, organic, or homemade baby food |
| Natural, organic, or plant-based cleaning products |
| Natural, organic, or plant-based personal care products |
| Natural or organic pet food or pet products |
| Allergy-free foods |
| Gluten-free foods |
| Natural or organic foods |
| Natural or organic vitamins and supplements |
| None of the above |
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14
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* Do you exercise? If so, do you:
| Practice yoga |
| Run |
| Bike |
| Practice Pilates |
| Go to a gym |
| Walk |
| Attend a mom exercise class |
| I do not exercise |
| Other, please specify |
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15
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* Which social networking sites do you belong to, if any?
| Facebook |
| Twitter |
| Linkedin |
| Youtube |
| Myspace |
| Foursquare |
| CafeMom |
| Meetup |
| Other (please specify) |
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16
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* Do you have a blog?
| Yes |
| No |
| If yes, what is the URL? |
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17
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Which, if any, of the following parenting websites do you regularly visit?
| BabyCenter |
| BabyZone |
| KIWI - KiwiMagOnline |
| Mothering |
| Parents |
| Earth's Best |
| WebMD |
| Parenting |
| Family Fun |
| iVillage |
| Ask Dr. Sears |
| Cafemom |
| DrGreene |
| Whole Foods |
| Cookie |
| Babble |
| Other, please specify |
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18
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What magazines have you read in the past two months?
| KIWI |
| Parenting |
| Parents |
| Family Fun |
| Better Home and Gardens |
| Family Circle |
| American Baby |
| Wonder Time |
| Fit Pregnancy |
| Lamaze |
| Natural Health |
| Whole Living - formerly Body & Soul |
| Real Simple |
| Vegetarian Times |
| Eating Well |
| Organic Gardening |
| Other, please specify |
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19
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* What do you hope to gain most from being a Mom Ambassador?
| An opportunity for my friends and I to get together and talk |
| A way to meet new friends who are moms |
| A way to learn more about raising healthier kids |
| A way to learn more about living a green lifestyle |
| A way to share what I know with others |
| A way to use my leadership skills while not in the workforce |
| A way to sample products or services from sponsoring companies |
| Other, please specify |
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20
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* Do you currently lead a moms group?
| Yes, I lead a moms group. |
| Not yet, but I am interested in starting one. |
| No, but I participate in one and would like to lead a Moms Meet group. |
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