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Fill up the form below and stand a chance for a shampoo trial!
1.
Name
2.
Age
[select]
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50 years above
3.
Gender
[select]
Male
Female
4.
Address
5.
Email
6.
Blog (Optional)
7.
Contact No.
8.
Occupation
9.
Industry
10.
Hair Length
[select]
Short (above ear)
Middle (above shoulder)
Semi-long (shoulder length)
Long (below shoulder)
11.
Hair Type
(May select more than one)
Normal
Oily
Dry
Damaged
12.
Hair Concerns
(May select more than one)
Hair is difficult to manage
Oily scalp
Dandruff
Frizzy and unruly hair
Split ends
Dry ends
Hard to comb through
Dull/ no shine
Hair loss
White/grey hair
Itchy scalp
13.
Ideal Hair
Light & Bouncy
Smooth & Manageable
14.
Have you had any chemical treatments done to your hair?
Yes
No
If yes, what chemical treatment have you done in the past 6 months?
Perming
Rebonding
Colouring
Others
(Please state if tick others)
Submit
M1 Singapore Fringe Festival 2012
