First name*
Last name*
Birthday*
Email*
Contact number*
Occupation
--Please select an option
Chiropractor
Dentist
Dietitian or Nutritionist
Nursing, Psychiatric, or Home Health Aide
Occupational and Physical Therapist Assistant or Aide
Optometrist
Pharmacist
Physician
Physician Assistant
Podiatrist
Registered Nurse
Therapist
Veterinarian
Health Technologist or Technician
Other Healthcare Practitioners and Technical Occupation
Chief Executive
General and Operations Manager
Advertising, Marketing, Promotions, Public Relations, and Sales Manager
Operations Specialties Manager (e.g., IT or HR Manager)
Construction Manager
Engineering Manager
Accountant, Auditor
Business Operations or Financial Specialist
Business Owner
Other Business, Executive, Management, Financial Occupation
Architect, Surveyor, or Cartographer
Engineer
Other Architecture and Engineering Occupation
Lecturer
Primary, Secondary, or Special Education School Teacher
Other Teacher or Instructor
Other Education, Training, and Library Occupation
Arts, Design, Entertainment, Sports, and Media Occupations
Computer Specialist, Mathematical Science
Counselor, Social Worker, or Other Community and Social Service Specialist
Lawyer, Judge
Life Scientist (e.g., Animal, Food, Soil, or Biological Scientist, Zoologist)
Physical Scientist (e.g., Astronomer, Physicist, Chemist, Hydrologist)
Religious Worker (e.g., Clergy, Director of Religious Activities or Education)
Social Scientist and Related Worker
Other Professional Occupation
Supervisor of Administrative Support Workers
Financial Clerk
Secretary or Administrative Assistant
Material Recording, Scheduling, and Dispatching Worker
Other Office and Administrative Support Occupation
Protective Service (e.g., Fire Fighting, Police Officer, Correctional Officer)
Chef or Head Cook
Cook or Food Preparation Worker
Food and Beverage Serving Worker (e.g., Bartender, Waiter, Waitress)
Building and Grounds Cleaning and Maintenance
Personal Care and Service (e.g., Hairdresser, Flight Attendant, Concierge)
Sales Supervisor, Retail Sales
Retail Sales Worker
Insurance Sales Agent
Sales Representative
Real Estate Sales Agent
Other Services Occupation
Construction and Extraction (e.g., Construction Laborer, Electrician)
Farming, Fishing, and Forestry
Installation, Maintenance, and Repair
Production Occupations
Other Agriculture, Maintenance, Repair, and Skilled Crafts Occupation
Aircraft Pilot or Flight Engineer
Motor Vehicle Operator (e.g., Ambulance, Bus, Taxi, or Truck Driver)
Other Transportation Occupation
Military
Homemaker
Any other occupation
Don't Know
Not Applicable
Do you have any dietary requirements?
Do you have any physical mobility needs?
