Client Profile

Strictly Confidential

Contact Details

Name:	*
Address:	*
Suburb:	*
State:	ACT NSW NT SA TAS VIC WA          Postcode:  *
Phone:	*
Email:	*
Current Occupation:	*

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How did you find out about Christina Shine and Make Your Image Shine? Internet Search Engine Interent Business Directory Business Card Brochure Friend Other Please Specify

Please describe in a few words the main reason for your consultation?

Please choose any of the following items you feel or fear relates to you:

Not dressing in sync with friends Not visually meeting the expected image at work Not dressing fashionable enough Being in a style/colour rut

Dressing too young Dressing too old Other - please specify

Please choose the items that you would you like help with:

Discovering what clothing styles suit you best How to coodinate clothes and colours Which colours suit you best Shopping and fashion sense Professional presentation Wardrobe organisation

Hair style and/or hair colour Accessorising Makeup Other - please specify

Please choose any of the following items that concern you:

Style Of Dress Make Up Career Age

Weight Height Shape Bust

Skin Hair Nails Teeth

Voice Other - please specify

Please choose the items you most require:

Business Socialising

Entertaining Home

Special Occasion Travel

Other - please specify

Please choose your preferences:

Separates Suits Dresses Quality Quantity

Tailored Loose Body Hugging Solid Colours Prints & Patterns

Bright Colours Dark Colours Light Colours Neutral Colours Medium Colours

Classic Current Trendy Styles Other - please specify

* Denotes required fields

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Phone: 0404 014 775
Email: info@makeyourimageshine.com.au
Location: Oakleigh South, Melbourne, Victoria