gs24-registration.personatech.com
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URL:
https://gs24-registration.personatech.com/form/initiate?fId=MzU1OGRkOWItY2Y4ZC00MDY4LTlkY2ItNzhlYTA4YzI0MGYy&OTID=0775243f-1b8b-485b-b3db-...
Submission: On July 18 via manual from IN — Scanned from DE
Submission: On July 18 via manual from IN — Scanned from DE
Form analysis 1 forms found in the DOM
#
<form action="#" class="form--flex" data-hs-cf-bound="true">
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Pronouns</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="radioBtnGroup radioBtnGroup--horizontal">
<div class="radioBtn"><label><input type="radio" name="a34efb9b-5587-4e9c-b53c-bef02d32b43b" class="radioBtn_input" value="MR"><b class="radioBtn_circle smooth"></b><span class="radioBtn_text smooth">He/Him</span></label></div>
<div class="radioBtn"><label><input type="radio" name="a34efb9b-5587-4e9c-b53c-bef02d32b43b" class="radioBtn_input" value="MS"><b class="radioBtn_circle smooth"></b><span class="radioBtn_text smooth">She/Her</span></label></div>
<div class="radioBtn"><label><input type="radio" name="a34efb9b-5587-4e9c-b53c-bef02d32b43b" class="radioBtn_input" value="MX"><b class="radioBtn_circle smooth"></b><span class="radioBtn_text smooth">They/Them</span></label></div>
<div class="radioBtn"><label><input type="radio" name="a34efb9b-5587-4e9c-b53c-bef02d32b43b" class="radioBtn_input" value="UNREVEALED"><b class="radioBtn_circle smooth"></b><span class="radioBtn_text smooth">Prefer not to say</span></label>
</div>
</div>
</div>
<div class="form_item"><label for="47517403-0677-4f76-b866-a0f35b7e49d9" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>First Name</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="inputBox"><input id="47517403-0677-4f76-b866-a0f35b7e49d9" type="text" name="47517403-0677-4f76-b866-a0f35b7e49d9" data-testid="47517403-0677-4f76-b866-a0f35b7e49d9" value=""></div>
</div>
<div class="form_item"><label for="702d9ef6-55f8-4a88-86e0-61ef1591a750" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Last Name</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="inputBox"><input id="702d9ef6-55f8-4a88-86e0-61ef1591a750" type="text" name="702d9ef6-55f8-4a88-86e0-61ef1591a750" data-testid="702d9ef6-55f8-4a88-86e0-61ef1591a750" value=""></div>
</div>
<div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Mobile Number</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="mobileNumber_wrapper">
<div class="customSelect_dropdown_wrapper customSelect_dropdown">
<div class="customSelect_dropdown_selectedOption_details">
<span class="customSelect_dropdown_selectedOption_details_additionalOption cflag US"></span>
<small class="customSelect_dropdown_selectedOption_details_code">+1</small>
</div>
<div class="customSelect_dropdown_list_wrapper">
<div class="xsVisible customSelect_dropdown_list_header"><b>Select Country Code</b><span class="customSelect_dropdown_list_close"><svg stroke="currentColor" fill="currentColor" stroke-width="0" xmlns="http://www.w3.org/2000/svg"
viewBox="0 0 24 24" width="1em" height="1em" data-testid="icon-">
<path d="M19 6.41L17.59 5 12 10.59 6.41 5 5 6.41 10.59 12 5 17.59 6.41 19 12 13.41 17.59 19 19 17.59 13.41 12z"></path>
</svg></span></div>
</div>
<div class="customSelect_dropdown_overlay smooth xsVisible"></div>
</div>
<div class="inputBox"><input id="14bbd95c-9959-4f1e-8745-77868667f03e" type="text" name="14bbd95c-9959-4f1e-8745-77868667f03e" data-testid="14bbd95c-9959-4f1e-8745-77868667f03e" value=""></div>
</div>
</div>
<div class="transformToLowerCase form_item"><label for="57915f4b-6fd7-4d93-8466-8a83a2711ba5" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">Work Email</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="transformToLowerCase inputBox"><input id="57915f4b-6fd7-4d93-8466-8a83a2711ba5" type="text" name="57915f4b-6fd7-4d93-8466-8a83a2711ba5" data-testid="57915f4b-6fd7-4d93-8466-8a83a2711ba5" value=""></div>
</div>
<div class="transformToLowerCase form_item"><label for="47551ea6-5c39-4057-9a41-1c553920ee6a" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Alternate Email</p>
</span><span title="" class="form_label_additionalNote"><i><p>(will be copied on all emails)</p></i></span></span></label></label></label>
<div class="transformToLowerCase inputBox"><input id="47551ea6-5c39-4057-9a41-1c553920ee6a" type="text" name="47551ea6-5c39-4057-9a41-1c553920ee6a" data-testid="47551ea6-5c39-4057-9a41-1c553920ee6a" value=""></div>
</div>
<div class="form_item"><label for="706d8263-011c-4104-a976-d9c2c702df61" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Your LinkedIn Profile URL</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="inputBox"><input id="706d8263-011c-4104-a976-d9c2c702df61" type="text" name="706d8263-011c-4104-a976-d9c2c702df61" data-testid="706d8263-011c-4104-a976-d9c2c702df61" value=""></div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="4454d107-c2f5-4882-8d6b-678ac3ac60f9"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label class="dynamicLabel"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">I have an Assistant</span><span title=""
class="form_label_additionalNote"><i>(your Assistant will be copied on all emails)</i></span></span></label></label></span></span></label></div>
</div>
<div class="form_item"><label id="0382b500-aa45-4941-86dd-7f73410b69a7" for="0382b500-aa45-4941-86dd-7f73410b69a7" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Time Zone</p>
</span><span class="dynamicLabel_asterisk"></span><span title="" class="form_label_additionalNote"><i><p>(for display purposes only)</p></i></span></span></label></label><span class="form_label--required">*</span></label>
<div class="selectDropdown_wrapper">
<div class="selectDropdown css-b62m3t-container"><span id="react-select-2-live-region" class="css-7pg0cj-a11yText"></span><span aria-live="polite" aria-atomic="false" aria-relevant="additions text" class="css-7pg0cj-a11yText"></span>
<div class="selectDropdown__control css-1s2u09g-control">
<div class="selectDropdown__value-container css-1d8n9bt">
<div class="selectDropdown__placeholder css-14el2xx-placeholder" id="react-select-2-placeholder">Select...</div>
<div class="selectDropdown__input-container css-ackcql" data-value=""><input class="selectDropdown__input" autocapitalize="none" autocomplete="off" autocorrect="off" id="0382b500-aa45-4941-86dd-7f73410b69a7-input" spellcheck="false"
tabindex="0" type="text" aria-autocomplete="list" aria-expanded="false" aria-haspopup="true" aria-controls="react-select-2-listbox" aria-owns="react-select-2-listbox" aria-labelledby="0382b500-aa45-4941-86dd-7f73410b69a7"
role="combobox" aria-describedby="react-select-2-placeholder" value=""
style="color: inherit; background: 0px center; opacity: 1; width: 100%; grid-area: 1 / 2; font: inherit; min-width: 2px; border: 0px; margin: 0px; outline: 0px; padding: 0px;"></div>
</div>
<div class="selectDropdown__indicators css-1wy0on6"><span class="selectDropdown__indicator-separator css-1okebmr-indicatorSeparator"></span>
<div class="selectDropdown__indicator selectDropdown__dropdown-indicator css-tlfecz-indicatorContainer" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" class="css-8mmkcg">
<path
d="M4.516 7.548c0.436-0.446 1.043-0.481 1.576 0l3.908 3.747 3.908-3.747c0.533-0.481 1.141-0.446 1.574 0 0.436 0.445 0.408 1.197 0 1.615-0.406 0.418-4.695 4.502-4.695 4.502-0.217 0.223-0.502 0.335-0.787 0.335s-0.57-0.112-0.789-0.335c0 0-4.287-4.084-4.695-4.502s-0.436-1.17 0-1.615z">
</path>
</svg></div>
</div>
</div><input name="0382b500-aa45-4941-86dd-7f73410b69a7" type="hidden" value="">
</div>
</div>
</div>
<div class="form_item"><label id="f3de2365-e7bd-4752-8d36-3a777e6a4076" for="f3de2365-e7bd-4752-8d36-3a777e6a4076" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Country</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="selectDropdown_wrapper">
<div class="selectDropdown css-b62m3t-container"><span id="react-select-3-live-region" class="css-7pg0cj-a11yText"></span><span aria-live="polite" aria-atomic="false" aria-relevant="additions text" class="css-7pg0cj-a11yText"></span>
<div class="selectDropdown__control css-1s2u09g-control">
<div class="selectDropdown__value-container css-1d8n9bt">
<div class="selectDropdown__placeholder css-14el2xx-placeholder" id="react-select-3-placeholder">Select...</div>
<div class="selectDropdown__input-container css-ackcql" data-value=""><input class="selectDropdown__input" autocapitalize="none" autocomplete="off" autocorrect="off" id="f3de2365-e7bd-4752-8d36-3a777e6a4076-input" spellcheck="false"
tabindex="0" type="text" aria-autocomplete="list" aria-expanded="false" aria-haspopup="true" aria-controls="react-select-3-listbox" aria-owns="react-select-3-listbox" aria-labelledby="f3de2365-e7bd-4752-8d36-3a777e6a4076"
role="combobox" aria-describedby="react-select-3-placeholder" value=""
style="color: inherit; background: 0px center; opacity: 1; width: 100%; grid-area: 1 / 2; font: inherit; min-width: 2px; border: 0px; margin: 0px; outline: 0px; padding: 0px;"></div>
</div>
<div class="selectDropdown__indicators css-1wy0on6"><span class="selectDropdown__indicator-separator css-1okebmr-indicatorSeparator"></span>
<div class="selectDropdown__indicator selectDropdown__dropdown-indicator css-tlfecz-indicatorContainer" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" class="css-8mmkcg">
<path
d="M4.516 7.548c0.436-0.446 1.043-0.481 1.576 0l3.908 3.747 3.908-3.747c0.533-0.481 1.141-0.446 1.574 0 0.436 0.445 0.408 1.197 0 1.615-0.406 0.418-4.695 4.502-4.695 4.502-0.217 0.223-0.502 0.335-0.787 0.335s-0.57-0.112-0.789-0.335c0 0-4.287-4.084-4.695-4.502s-0.436-1.17 0-1.615z">
</path>
</svg></div>
</div>
</div><input name="f3de2365-e7bd-4752-8d36-3a777e6a4076" type="hidden" value="">
</div>
</div>
</div>
<div class="form_item"><label for="0dea911f-0507-4f9c-987e-3ce2b158c94d" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Address</p>
</span></span></label></label></label>
<div class="inputBox"><input id="0dea911f-0507-4f9c-987e-3ce2b158c94d" type="text" name="0dea911f-0507-4f9c-987e-3ce2b158c94d" data-testid="0dea911f-0507-4f9c-987e-3ce2b158c94d" value=""></div>
</div>
<div class="form_item"><label for="2406379a-889c-43de-8c51-b51a7bb200be" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Suite, Apt, etc.</p>
</span></span></label></label></label>
<div class="inputBox"><input id="2406379a-889c-43de-8c51-b51a7bb200be" type="text" name="2406379a-889c-43de-8c51-b51a7bb200be" data-testid="2406379a-889c-43de-8c51-b51a7bb200be" value=""></div>
</div>
<div class="form_item"><label for="d0f28547-ac9c-451b-a1a8-29d966c537fa" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>City/Locality</p>
</span></span></label></label></label>
<div class="inputBox"><input id="d0f28547-ac9c-451b-a1a8-29d966c537fa" type="text" name="d0f28547-ac9c-451b-a1a8-29d966c537fa" data-testid="d0f28547-ac9c-451b-a1a8-29d966c537fa" value=""></div>
</div>
<div class="form_item"><label for="62515004-53ea-4834-971f-7a006c92b41d" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>State/Region</p>
</span></span></label></label></label>
<div class="inputBox"><input id="62515004-53ea-4834-971f-7a006c92b41d" type="text" name="62515004-53ea-4834-971f-7a006c92b41d" data-testid="62515004-53ea-4834-971f-7a006c92b41d" value=""></div>
</div>
<div class="form_item"><label for="c9eea627-451b-4fcf-b29b-aa28d976d4dd" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Zip/Postal Code</p>
</span></span></label></label></label>
<div class="inputBox"><input id="c9eea627-451b-4fcf-b29b-aa28d976d4dd" type="text" name="c9eea627-451b-4fcf-b29b-aa28d976d4dd" data-testid="c9eea627-451b-4fcf-b29b-aa28d976d4dd" value=""></div>
</div>
<div class="form_item form_item--fullWidth">
<hr>
</div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p><b>Your Organization</b></p>
</span></span></label></label></label></div>
<div class="form_item"><label for="430ecdcd-d3c8-4dd9-852a-7c8d5197eb8d" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">Organization Name</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div></div>
<div class="inputBox" data-reach-combobox="" data-state="idle"><input aria-autocomplete="both" aria-controls="listbox--:r0:" aria-expanded="false" aria-haspopup="listbox" role="combobox" placeholder="" data-reach-combobox-input=""
data-state="idle" value=""></div>
</div>
<div class="form_item"><label for="5cb2e601-5dff-4bf7-972a-79d0b7831872" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">Organization URL</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="inputBox"><input id="5cb2e601-5dff-4bf7-972a-79d0b7831872" type="text" name="5cb2e601-5dff-4bf7-972a-79d0b7831872" data-testid="5cb2e601-5dff-4bf7-972a-79d0b7831872" value=""></div>
</div>
<div class="form_item"><label id="5592de3a-7fb2-4f13-a3d0-a1a8675b76aa" for="5592de3a-7fb2-4f13-a3d0-a1a8675b76aa" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Describe your organization based on your primary job function</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="selectDropdown_wrapper">
<div class="selectDropdown css-b62m3t-container"><span id="react-select-4-live-region" class="css-7pg0cj-a11yText"></span><span aria-live="polite" aria-atomic="false" aria-relevant="additions text" class="css-7pg0cj-a11yText"></span>
<div class="selectDropdown__control css-1s2u09g-control">
<div class="selectDropdown__value-container css-1d8n9bt">
<div class="selectDropdown__placeholder css-14el2xx-placeholder" id="react-select-4-placeholder">Select...</div>
<div class="selectDropdown__input-container css-ackcql" data-value=""><input class="selectDropdown__input" autocapitalize="none" autocomplete="off" autocorrect="off" id="5592de3a-7fb2-4f13-a3d0-a1a8675b76aa-input" spellcheck="false"
tabindex="0" type="text" aria-autocomplete="list" aria-expanded="false" aria-haspopup="true" aria-controls="react-select-4-listbox" aria-owns="react-select-4-listbox" aria-labelledby="5592de3a-7fb2-4f13-a3d0-a1a8675b76aa"
role="combobox" aria-describedby="react-select-4-placeholder" value=""
style="color: inherit; background: 0px center; opacity: 1; width: 100%; grid-area: 1 / 2; font: inherit; min-width: 2px; border: 0px; margin: 0px; outline: 0px; padding: 0px;"></div>
</div>
<div class="selectDropdown__indicators css-1wy0on6"><span class="selectDropdown__indicator-separator css-1okebmr-indicatorSeparator"></span>
<div class="selectDropdown__indicator selectDropdown__dropdown-indicator css-tlfecz-indicatorContainer" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" class="css-8mmkcg">
<path
d="M4.516 7.548c0.436-0.446 1.043-0.481 1.576 0l3.908 3.747 3.908-3.747c0.533-0.481 1.141-0.446 1.574 0 0.436 0.445 0.408 1.197 0 1.615-0.406 0.418-4.695 4.502-4.695 4.502-0.217 0.223-0.502 0.335-0.787 0.335s-0.57-0.112-0.789-0.335c0 0-4.287-4.084-4.695-4.502s-0.436-1.17 0-1.615z">
</path>
</svg></div>
</div>
</div><input name="5592de3a-7fb2-4f13-a3d0-a1a8675b76aa" type="hidden" value="">
</div>
</div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkboxGroup checkboxGroup--md">
<div class="checkboxGroup_labelWrapper"><label for="" class="checkboxGroup_title form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Retailer/Brand Vertical</p>
</span><span class="dynamicLabel_asterisk"></span><span title="" class="form_label_additionalNote"><i><p>(select up to 3)</p></i></span></span></label></label><span class="form_label--required">*</span></label></div>
<div class="checkboxGroup_wrapper">
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="be8a67aa-36e3-4f06-81d3-d6f035f3f7d3"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Apparel &
Accessories</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="b1ad0244-a8f8-488c-8b77-097d28eefed9"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Automotive</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="d9df9391-ea79-4c00-b65e-efe2f8146ad3"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Beauty &
Cosmetics</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="c63e7d3c-1aae-4b7b-a2e5-68fd9d7dbeae"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Beverage Alcohol</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="c87796ae-49a5-4a0f-87cd-47a0f08ba570"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Consumer Electronics &
Technology</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="a100a2c1-b729-4b43-b20f-f215fe511c72"><b></b><span class="checkbox_text"><span class="checkbox_text--value">CPG</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="5bc3a86c-8d82-4df6-9044-4a02fca99ef7"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Department Stores & Super
Stores</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="48d5bbd6-57f0-4532-820e-885f47a65580"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Discount Stores</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="dc868743-82e9-4eb2-bc0b-fd95f2ffed3f"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Entertainment, Media &
Publishing</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="a52366fa-4764-4136-bb3c-007da425907e"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Flowers, Gifts &
Specialty</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="09f4fe32-e306-46e7-b18a-5fbf7b07f267"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Food CPG</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="5f10eb92-b440-4b8e-8ce9-05313f99175f"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Gas Station & Convenience
Stores</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="2e1f0fef-22e0-451b-ae1a-a77cdfbad485"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Grocery</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="7054ef50-66a4-47c2-b7dd-d8750a93ee27"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Health &
Healthcare</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="5f591412-9dbc-4927-908e-faaf08832a27"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Home &
Furniture</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="0af0e34e-c2cd-4dff-965e-b8fb1f2fdeee"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Home Improvement</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="34ba688b-66cd-4b15-bd19-3347806cc368"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Luxury</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="458baf70-0f8f-47f5-94f2-1609268546fd"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Marketplace</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="2e9a012a-18d6-4182-8952-e39fe4853a77"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Pet Products</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="16110cbc-9697-4cb0-8965-56266923df2f"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Pharmacy & Drug
Stores</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="93341b49-a562-491a-bbcd-064e5cc89dc8"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Restaurants & QSR (Quick Service
Restaurants)</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="3978de2a-aeda-4202-b5f6-4211f435b8d9"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Sporting & Recreational
Equipment</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1c32de4e-f1db-44b0-bcbe-1034dd19d496"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Travel, Hotels &
Hospitality</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="55f07b31-3f8c-40b4-b4d7-c18c2be94560"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Toys, Books &
Games</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="b4e64adf-5574-453d-aeda-5c509428633b"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Other</span></span></label></div>
</div>
</div>
</div>
<div class="form_item"><label id="08b86f4b-d973-4305-a107-5ba324d40e88" for="08b86f4b-d973-4305-a107-5ba324d40e88" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>What is the stage of your organization?</p>
</span><span class="dynamicLabel_asterisk"></span><span class="tooltipIconWrapper tooltipIconWrapper--withDefaultIcon"><span class="toolTip_icon toolTip_icon--default toolTip_icon--sm"><svg stroke="currentColor" fill="currentColor"
stroke-width="0" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 16 16" width="1em" height="1em" data-testid="icon-">
<path d="M8.93 6.588l-2.29.287-.082.38.45.083c.294.07.352.176.288.469l-.738 3.468c-.194.897.105 1.319.808 1.319.545 0 1.178-.252 1.465-.598l.088-.416c-.2.176-.492.246-.686.246-.275 0-.375-.193-.304-.533L8.93 6.588z"></path>
<circle cx="8" cy="4.5" r="1"></circle>
</svg></span></span></span></label></label><span class="form_label--required">*</span></label>
<div class="selectDropdown_wrapper">
<div class="selectDropdown css-b62m3t-container"><span id="react-select-5-live-region" class="css-7pg0cj-a11yText"></span><span aria-live="polite" aria-atomic="false" aria-relevant="additions text" class="css-7pg0cj-a11yText"></span>
<div class="selectDropdown__control css-1s2u09g-control">
<div class="selectDropdown__value-container css-1d8n9bt">
<div class="selectDropdown__placeholder css-14el2xx-placeholder" id="react-select-5-placeholder">Select...</div><input id="08b86f4b-d973-4305-a107-5ba324d40e88-input" tabindex="0" inputmode="none" aria-autocomplete="list"
aria-expanded="false" aria-haspopup="true" aria-controls="react-select-5-listbox" aria-owns="react-select-5-listbox" aria-labelledby="08b86f4b-d973-4305-a107-5ba324d40e88" role="combobox" aria-readonly="true"
aria-describedby="react-select-5-placeholder" class="css-1hac4vs-dummyInput" value="">
</div>
<div class="selectDropdown__indicators css-1wy0on6"><span class="selectDropdown__indicator-separator css-1okebmr-indicatorSeparator"></span>
<div class="selectDropdown__indicator selectDropdown__dropdown-indicator css-tlfecz-indicatorContainer" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" class="css-8mmkcg">
<path
d="M4.516 7.548c0.436-0.446 1.043-0.481 1.576 0l3.908 3.747 3.908-3.747c0.533-0.481 1.141-0.446 1.574 0 0.436 0.445 0.408 1.197 0 1.615-0.406 0.418-4.695 4.502-4.695 4.502-0.217 0.223-0.502 0.335-0.787 0.335s-0.57-0.112-0.789-0.335c0 0-4.287-4.084-4.695-4.502s-0.436-1.17 0-1.615z">
</path>
</svg></div>
</div>
</div><input name="08b86f4b-d973-4305-a107-5ba324d40e88" type="hidden" value="">
</div>
</div>
</div>
<div class="form_item"><label id="94add32a-c1c2-4fe9-8c4d-180f9a69290a" for="94add32a-c1c2-4fe9-8c4d-180f9a69290a" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>What is your total annual revenue?</p>
</span><span class="dynamicLabel_asterisk"></span><span class="tooltipIconWrapper tooltipIconWrapper--withDefaultIcon"><span class="toolTip_icon toolTip_icon--default toolTip_icon--sm"><svg stroke="currentColor" fill="currentColor"
stroke-width="0" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 16 16" width="1em" height="1em" data-testid="icon-">
<path d="M8.93 6.588l-2.29.287-.082.38.45.083c.294.07.352.176.288.469l-.738 3.468c-.194.897.105 1.319.808 1.319.545 0 1.178-.252 1.465-.598l.088-.416c-.2.176-.492.246-.686.246-.275 0-.375-.193-.304-.533L8.93 6.588z"></path>
<circle cx="8" cy="4.5" r="1"></circle>
</svg></span></span></span></label></label><span class="form_label--required">*</span></label>
<div class="selectDropdown_wrapper">
<div class="selectDropdown css-b62m3t-container"><span id="react-select-6-live-region" class="css-7pg0cj-a11yText"></span><span aria-live="polite" aria-atomic="false" aria-relevant="additions text" class="css-7pg0cj-a11yText"></span>
<div class="selectDropdown__control css-1s2u09g-control">
<div class="selectDropdown__value-container css-1d8n9bt">
<div class="selectDropdown__placeholder css-14el2xx-placeholder" id="react-select-6-placeholder">Select...</div><input id="94add32a-c1c2-4fe9-8c4d-180f9a69290a-input" tabindex="0" inputmode="none" aria-autocomplete="list"
aria-expanded="false" aria-haspopup="true" aria-controls="react-select-6-listbox" aria-owns="react-select-6-listbox" aria-labelledby="94add32a-c1c2-4fe9-8c4d-180f9a69290a" role="combobox" aria-readonly="true"
aria-describedby="react-select-6-placeholder" class="css-1hac4vs-dummyInput" value="">
</div>
<div class="selectDropdown__indicators css-1wy0on6"><span class="selectDropdown__indicator-separator css-1okebmr-indicatorSeparator"></span>
<div class="selectDropdown__indicator selectDropdown__dropdown-indicator css-tlfecz-indicatorContainer" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" class="css-8mmkcg">
<path
d="M4.516 7.548c0.436-0.446 1.043-0.481 1.576 0l3.908 3.747 3.908-3.747c0.533-0.481 1.141-0.446 1.574 0 0.436 0.445 0.408 1.197 0 1.615-0.406 0.418-4.695 4.502-4.695 4.502-0.217 0.223-0.502 0.335-0.787 0.335s-0.57-0.112-0.789-0.335c0 0-4.287-4.084-4.695-4.502s-0.436-1.17 0-1.615z">
</path>
</svg></div>
</div>
</div><input name="94add32a-c1c2-4fe9-8c4d-180f9a69290a" type="hidden" value="">
</div>
</div>
</div>
<div class="form_item"><label id="2f2addfb-b606-420e-989d-85530a290966" for="2f2addfb-b606-420e-989d-85530a290966" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>What is your annual online revenue?</p>
</span><span class="dynamicLabel_asterisk"></span><span class="tooltipIconWrapper tooltipIconWrapper--withDefaultIcon"><span class="toolTip_icon toolTip_icon--default toolTip_icon--sm"><svg stroke="currentColor" fill="currentColor"
stroke-width="0" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 16 16" width="1em" height="1em" data-testid="icon-">
<path d="M8.93 6.588l-2.29.287-.082.38.45.083c.294.07.352.176.288.469l-.738 3.468c-.194.897.105 1.319.808 1.319.545 0 1.178-.252 1.465-.598l.088-.416c-.2.176-.492.246-.686.246-.275 0-.375-.193-.304-.533L8.93 6.588z"></path>
<circle cx="8" cy="4.5" r="1"></circle>
</svg></span></span></span></label></label><span class="form_label--required">*</span></label>
<div class="selectDropdown_wrapper">
<div class="selectDropdown css-b62m3t-container"><span id="react-select-7-live-region" class="css-7pg0cj-a11yText"></span><span aria-live="polite" aria-atomic="false" aria-relevant="additions text" class="css-7pg0cj-a11yText"></span>
<div class="selectDropdown__control css-1s2u09g-control">
<div class="selectDropdown__value-container css-1d8n9bt">
<div class="selectDropdown__placeholder css-14el2xx-placeholder" id="react-select-7-placeholder">Select...</div><input id="2f2addfb-b606-420e-989d-85530a290966-input" tabindex="0" inputmode="none" aria-autocomplete="list"
aria-expanded="false" aria-haspopup="true" aria-controls="react-select-7-listbox" aria-owns="react-select-7-listbox" aria-labelledby="2f2addfb-b606-420e-989d-85530a290966" role="combobox" aria-readonly="true"
aria-describedby="react-select-7-placeholder" class="css-1hac4vs-dummyInput" value="">
</div>
<div class="selectDropdown__indicators css-1wy0on6"><span class="selectDropdown__indicator-separator css-1okebmr-indicatorSeparator"></span>
<div class="selectDropdown__indicator selectDropdown__dropdown-indicator css-tlfecz-indicatorContainer" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" class="css-8mmkcg">
<path
d="M4.516 7.548c0.436-0.446 1.043-0.481 1.576 0l3.908 3.747 3.908-3.747c0.533-0.481 1.141-0.446 1.574 0 0.436 0.445 0.408 1.197 0 1.615-0.406 0.418-4.695 4.502-4.695 4.502-0.217 0.223-0.502 0.335-0.787 0.335s-0.57-0.112-0.789-0.335c0 0-4.287-4.084-4.695-4.502s-0.436-1.17 0-1.615z">
</path>
</svg></div>
</div>
</div><input name="2f2addfb-b606-420e-989d-85530a290966" type="hidden" value="">
</div>
</div>
</div>
<div class="form_item form_item--fullWidth">
<hr>
</div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p><b>Your Role</b></p>
</span></span></label></label></label></div>
<div class="form_item"><label for="c8ef131f-35eb-4807-a7b5-1126d005e7bb" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Job Title</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="inputBox"><input id="c8ef131f-35eb-4807-a7b5-1126d005e7bb" type="text" name="c8ef131f-35eb-4807-a7b5-1126d005e7bb" data-testid="c8ef131f-35eb-4807-a7b5-1126d005e7bb" value=""></div>
</div>
<div class="form_item"><label id="b8d1f84b-7433-4e9c-9e26-a52e299d08e9" for="b8d1f84b-7433-4e9c-9e26-a52e299d08e9" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Job Title Level </p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="selectDropdown_wrapper">
<div class="selectDropdown css-b62m3t-container"><span id="react-select-8-live-region" class="css-7pg0cj-a11yText"></span><span aria-live="polite" aria-atomic="false" aria-relevant="additions text" class="css-7pg0cj-a11yText"></span>
<div class="selectDropdown__control css-1s2u09g-control">
<div class="selectDropdown__value-container css-1d8n9bt">
<div class="selectDropdown__placeholder css-14el2xx-placeholder" id="react-select-8-placeholder">Select...</div><input id="b8d1f84b-7433-4e9c-9e26-a52e299d08e9-input" tabindex="0" inputmode="none" aria-autocomplete="list"
aria-expanded="false" aria-haspopup="true" aria-controls="react-select-8-listbox" aria-owns="react-select-8-listbox" aria-labelledby="b8d1f84b-7433-4e9c-9e26-a52e299d08e9" role="combobox" aria-readonly="true"
aria-describedby="react-select-8-placeholder" class="css-1hac4vs-dummyInput" value="">
</div>
<div class="selectDropdown__indicators css-1wy0on6"><span class="selectDropdown__indicator-separator css-1okebmr-indicatorSeparator"></span>
<div class="selectDropdown__indicator selectDropdown__dropdown-indicator css-tlfecz-indicatorContainer" aria-hidden="true"><svg height="20" width="20" viewBox="0 0 20 20" aria-hidden="true" focusable="false" class="css-8mmkcg">
<path
d="M4.516 7.548c0.436-0.446 1.043-0.481 1.576 0l3.908 3.747 3.908-3.747c0.533-0.481 1.141-0.446 1.574 0 0.436 0.445 0.408 1.197 0 1.615-0.406 0.418-4.695 4.502-4.695 4.502-0.217 0.223-0.502 0.335-0.787 0.335s-0.57-0.112-0.789-0.335c0 0-4.287-4.084-4.695-4.502s-0.436-1.17 0-1.615z">
</path>
</svg></div>
</div>
</div><input name="b8d1f84b-7433-4e9c-9e26-a52e299d08e9" type="hidden" value="">
</div>
</div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkboxGroup checkboxGroup--md">
<div class="checkboxGroup_labelWrapper"><label for="" class="checkboxGroup_title form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Job Function </p>
</span><span class="dynamicLabel_asterisk"></span><span title="" class="form_label_additionalNote"><i><p>(select up to 3)</p></i></span></span></label></label><span class="form_label--required">*</span></label></div>
<div class="checkboxGroup_wrapper">
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="c80143c9-37bb-41a5-8caa-fdf7f8f9daf6"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Consulting &
Advisory</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="70411122-3d0c-44d3-94f6-607cf0d8b91e"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Customer
Experience</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="52699cac-0d17-413d-840c-115df87078a6"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Data, Analytics &
Insights</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1a62f9a3-59bb-40a1-94b2-15e601b800a8"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Digital &
Ecommerce</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="e2394e85-516a-46cf-9d9c-b883d687f70c"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Environmental, Social & Corporate
Governance (ESG)</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="49d63027-b214-40b5-b17c-6367ace18823"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Executive Leadership & Board of
Directors</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="cb24344f-1612-45c7-b7d8-4e2e2e65d0e5"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Finance &
Accounting</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="41cc5147-7989-4c6a-8ab5-b99a3183fa40"><b></b><span class="checkbox_text"><span class="checkbox_text--value">HR, Talent Acquisition & Workforce
Management</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="b9a54860-0b81-42d9-ac02-eefba351ec32"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Investing</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="76d96c79-bdeb-462a-bd3a-cd725029dab3"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Legal, Compliance &
Risk</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="e5436da4-93d8-4b12-8808-b62829af26fa"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Logistics & Transportation (inc.
Last-Mile)</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="20e079aa-9ad4-4adc-a0fc-e14391b83dbc"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Marketing, Advertising &
Communications</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="7a551307-5c75-4b1d-8dfa-9bfd3fe75c5e"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Merchandising</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6c7fd677-d177-40a8-8972-464e32f1914e"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Partnerships</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="0c5a0970-5d81-4cf5-9c13-911b425b1fe8"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Procurement & Vendor
Management</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="e28e5aeb-440b-449d-b5f8-f872576dc411"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Product Development &
Management</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="57de8ef6-b3e2-4a1c-92cd-a441d4d9bebe"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Research, Content &
Journalism</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="2301e75a-6915-463d-afff-25bc758aeb88"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Sales, BD & Account
Management</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="28c14a28-eea5-4bfe-8082-df49c53fdb91"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Store Operations</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="67d4c523-569c-4523-9f15-4dcf8b77a409"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Strategy, Innovation &
Transformation</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="f2c54659-cdfe-4849-b418-277039784e1a"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Supply Chain, Operations &
Fulfillment</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="a5ea1281-f69b-43b5-863c-9fe267749b4c"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Technology &
IT</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="cd724e2b-f8a1-4e52-a45d-e270a46faa56"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Other</span></span></label></div>
</div>
</div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkboxGroup checkboxGroup--md">
<div class="checkboxGroup_labelWrapper"><label for="" class="checkboxGroup_title form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Buying Responsibility: I am</p>
</span><span class="dynamicLabel_asterisk"></span><span title="" class="form_label_additionalNote"><i><p>(select all that apply)</p></i></span></span></label></label><span class="form_label--required">*</span></label></div>
<div class="checkboxGroup_wrapper hasSingleOption">
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="11a1e449-fe14-4744-8045-1a58e25c6733"><b></b><span class="checkbox_text"><span class="checkbox_text--value">The budget owner or final decision maker
for ecommerce or retail solutions buying decisions</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="f61f8a39-a8f4-4427-a33d-81fb4e42add8"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Part of a team that makes ecommerce or
retail solutions buying decisions</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="73bd3b59-651a-4762-b720-ae1219cd5916"><b></b><span class="checkbox_text"><span class="checkbox_text--value">An influencer of ecommerce or retail
solutions buying decisions</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="b1726c61-56f6-4d4a-a1f6-f311c1560929"><b></b><span class="checkbox_text"><span class="checkbox_text--value">In procurement</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="5f505d38-abc6-42f6-8d17-d871c0fc5127"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Neither an influencer or buyer for
ecommerce or retail solutions</span></span></label></div>
</div>
</div>
</div>
<div class="form_item form_item--fullWidth"><label for="e1667ffb-256f-4b8c-8a89-52378d511c98" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title=""
class="dynamicLabel_primaryLabel">
<p>Please list the relevant areas that you oversee or influence (with respect to ecommerce or retail solutions)</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="textBox"><textarea data-testid="e1667ffb-256f-4b8c-8a89-52378d511c98" name="e1667ffb-256f-4b8c-8a89-52378d511c98" id="e1667ffb-256f-4b8c-8a89-52378d511c98" rows="4"></textarea><span class="textBox_count"><span>0 / 500</span></span>
</div>
</div>
<div class="form_item form_item--fullWidth">
<hr>
</div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p><b>Your Hosted Ticket</b></p>
</span></span></label></label></label></div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="09525328-9a57-474e-b11f-8964d7f0658d"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label
class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>I agree to participate in up to eight (8) 15-minute Hosted Program meetings (a total of two hours)</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label></span></span></label></div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="065ae6e7-73d5-46ab-b850-334019406c28"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label
class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>I agree to the
<a href="https://groceryshop.com/page/hosted-terms?__hstc=198363696.3e8ae37f8488be8cf79a67967ff30847.1721330030547.1721330030547.1721330030547.1&__hssc=198363696.1.1721330030547&__hsfp=321484724" target="_blank" rel="noopener">Groceryshop 2024 Hosted Program Terms for Retailers & Brands</a>
</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label></span></span></label></div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="a0816b58-b92e-4b69-b91d-117f65389109"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label
class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>I confirm that I am a retailer or brand (others do not qualify)</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label></span></span></label></div>
</div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>In addition to your requirement of up to eight (8) 15-minute onsite meetings with participating sponsors ("Hosted Meetings"), would you like to participate in non-Hosted Meetings? </p>
</span></span></label></label></label></div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>These are meetings with individuals (including those not from sponsors) participating in the meetings program. All meetings are double opt-in so that they are useful to everyone and are based on your individual availability.</p>
</span></span></label></label></label></div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>We recommend "Yes" to get the most out of the event</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label><span class="form_label--required">*</span></label>
<div class="radioBtnGroup radioBtnGroup--vertical">
<div class="radioBtn"><label><input type="radio" name="9b5ab2b7-fbb0-4986-9155-9cae06c49d4c" class="radioBtn_input" value="YES"><b class="radioBtn_circle smooth"></b><span class="radioBtn_text smooth">Yes, I'd like to get the most out of the
event with Hosted and Non-Hosted Meetings</span></label></div>
<div class="radioBtn"><label><input type="radio" name="9b5ab2b7-fbb0-4986-9155-9cae06c49d4c" class="radioBtn_input" value="NO"><b class="radioBtn_circle smooth"></b><span class="radioBtn_text smooth">No, I'll just do the required Hosted
Meetings</span></label></div>
</div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="39bb39db-1216-451e-a2c9-425541049a82"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label class="dynamicLabel"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>To OPT OUT of the $750 Reimbursement opt out travel/hotel reimbursement for any reason, check this box. If you want to receive the reimbursement, leave the box unchecked.</p>
</span></span></label></label></span></span></label></div>
</div>
<div class="form_item form_item--fullWidth">
<hr>
</div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p><b>The following questions are for us to help you make the most of your time onsite</b></p>
</span></span></label></label></label></div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="3a2615fe-f204-4c7a-8613-53466832ef2a"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label class="dynamicLabel"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p><b>As a Retailer or Brand, you can join our Retailers & Brands Networking Dinner Series (held on Mon, Oct 7), which we've designed to become a key new part of the Groceryshop experience starting in 2024.</b></p>
<p><b>Check this box if you're interested in joining other retailers and brands for amazing dinner experiences at top Las Vegas restaurants.</b></p>
</span></span></label></label></span></span></label></div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkboxGroup checkboxGroup--md">
<div class="checkboxGroup_labelWrapper"><label for="" class="checkboxGroup_title form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Topics of interest</p>
</span><span title="" class="form_label_additionalNote"><i><p>(select all that apply)</p></i></span></span></label></label></label></div>
<div class="checkboxGroup_wrapper">
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1e7ef386-36dc-4352-a741-c0722ce1f06b"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Seizing New Opportunities in Retail
Media</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="59323130-fb25-42ea-9964-d6b10209c11a"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Enabling AI, Data and Technology Across
the Organization</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="3368a2b9-f853-44a3-a0b7-18e9dea26dc8"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Reimagining Commercial
Partnerships</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="8b687ba0-bd31-4598-b4f8-9826df8f0ac7"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Executing Seamless and Unified Retail
Experiences</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="da8c952d-4227-4b3e-88c8-d1abbd20e95f"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Exceptional Marketing and Brand Building
Strategies</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="61dcaf99-f6cb-413e-8a93-fa1b98146b85"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Building Profitable Ecommerce
Businesses</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="de2e35fd-2ae0-456c-99b4-119993717730"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Unlocking Efficiencies in Supply Chain
and Store Operations</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="b7ce113b-bcd0-4bfa-be3f-cbddd787998c"><b></b><span class="checkbox_text"><span class="checkbox_text--value">New Approaches to Product Assortment,
Pricing and Promotion</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="99a43a75-1c08-4194-b167-1e3532a77185"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Adapting to the Evolving Economic
Climate</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="54da3f37-2f28-44b9-bcf5-30e6007e23bc"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Embracing New Consumer Habits and
Preferences</span></span></label></div>
</div>
</div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkboxGroup checkboxGroup--md">
<div class="checkboxGroup_labelWrapper"><label for="" class="checkboxGroup_title form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Your objectives for attending Groceryshop</p>
</span><span title="" class="form_label_additionalNote"><i><p>(select all that apply)</p></i></span></span></label></label></label></div>
<div class="checkboxGroup_wrapper hasSingleOption">
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="9d3fc106-fd5b-4842-86bf-c7108121886b"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Attend Sessions</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="b6aa5858-d291-4d65-955a-1335789ef81a"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Network and Make New
Contacts</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="33c4ae28-8980-458d-88c2-1119a42633cd"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Source New Technology
Solutions</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="7f50d332-c1da-4483-8dd3-7807da4c4456"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Raise Capital</span></span></label>
</div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="fa3b5abf-c60e-41a6-97fe-4eb5a89f4252"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Build Brand
Awareness</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="2abd2964-2666-46bd-9bd7-0feea7973823"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Gain Media
Exposure</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="0e07f11d-4011-4dd1-8da8-78c3535e9b1b"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Generate New Clients and
Leads</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="76e77cf7-7406-4cd7-9b89-1fa325116f7d"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Source Investment Opportunities and
Acquisitions</span></span></label></div>
</div>
</div>
</div>
<div class="form_item"><label for="07477a4d-7867-4944-b453-7ac8b5b9a5ed" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>When's your birthday?</p>
</span></span></label></label></label>
<div class="inputBox"><input id="07477a4d-7867-4944-b453-7ac8b5b9a5ed" type="text" name="07477a4d-7867-4944-b453-7ac8b5b9a5ed" data-testid="07477a4d-7867-4944-b453-7ac8b5b9a5ed" placeholder="e.g., Jan-01" value=""></div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="569c3c13-ac6a-4725-896a-33d767b22201"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label class="dynamicLabel"><label><span
class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Do you have any accessibility requirements you would like Groceryshop to be aware of to improve your onsite experience?</p>
</span></span></label></label></span></span></label></div>
</div>
<div class="form_item form_item--fullWidth">
<div class="checkboxGroup checkboxGroup--md">
<div class="checkboxGroup_labelWrapper"><label for="" class="checkboxGroup_title form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Do you have any dietary requirements?</p>
</span><span title="" class="form_label_additionalNote"><i><p>(select all that apply)</p></i></span></span></label></label></label></div>
<div class="checkboxGroup_wrapper">
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="VEGETARIAN"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Vegetarian</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="VEGAN"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Vegan</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="KOSHER"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Kosher</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="HALAL"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Halal</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="GLUTEN_INTOLERANT"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Gluten Intolerant</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="NON_LACTOSE"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Non Lactose</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="LOW_CONTENT"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Low Fat/Low Cholesterol/Low Calorie/Low
Sodium</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="DIABETIC"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Diabetic</span></span></label></div>
<div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="ALLERGY_OTHER"><b></b><span class="checkbox_text"><span class="checkbox_text--value">Allergy / Other</span></span></label></div>
</div>
</div>
</div>
<div class="form_item form_item--fullWidth">
<hr>
</div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p><b>Your Privacy</b></p>
</span></span></label></label></label></div>
<div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p><a href="https://hyve.group/Home" target="_blank" rel="noopener">Hyve Group</a> (Groceryshop's parent company) takes your privacy seriously – you can read more about this in our
<a href="https://hyve.group/Privacy-notice" target="_blank" rel="noopener">Privacy Notice</a>. We use your personal information to provide the services you have requested from us and for other carefully considered legitimate business
purposes. This includes sending you marketing communications and advertising about our events as well as information and publications which we think would be of interest to you. You have the right to object to this processing and, if
you wish to do so, you can update your preferences <a href="mailto:data.privacy@hyve.group" target="_blank" rel="noopener">here</a>. View a list of the events organised by Hyve Group
<a href="https://hyve.group/Events" target="_blank" rel="noopener">here</a>.</p>
</span></span></label></label></label></div>
<div class="form_item form_item--fullWidth">
<div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="d902c300-37d3-471c-9175-8b9675701d7f"><b></b><span class="checkbox_text"><span class="checkbox_text--value"><label
class="dynamicLabel dynamicLabel--required"><label><span class="dynamicLabel_primaryLabelWrapper"><span title="" class="dynamicLabel_primaryLabel">
<p>Groceryshop's technology provider, Personatech, processes data on behalf of Groceryshop to deliver event technology services. I have read and agree to the
<a href="https://personatech.com/termsOfUse" target="_blank" rel="noopener">Personatech Terms of Use</a> and acknowledge the
<a href="https://personatech.com/privacyPolicy" target="_blank" rel="noopener">Privacy Policy and Notice at Collection</a>.</p>
</span><span class="dynamicLabel_asterisk"></span></span></label></label></span></span></label></div>
</div>
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October 7-9, 2024
Mandalay Bay, Las Vegas
Qualified Retailers & Brands Can Get Free Groceryshop Tickets & Up To $750
Travel/Hotel Reimbursement
To qualify, individuals must (a) be directly employed by a retailer or brand,
and (b) be responsible for buying or evaluating retail or ecommerce technology
or other solutions for their organizations, and (c) take up to eight (8)
15-minute onsite meetings with participating sponsors ("Hosted Meetings"), which
are based on a double opt-in process so that they are useful to everyone.
You commit to being available for a minimum of 16 Meeting Time Slots, until you
receive your final schedule immediately prior to the event. Your final set of up
to eight (8) 15-minute Hosted Meetings may be spread across multiple Meeting
Times; they may not be back to back.
If you choose to, you can also participate in meetings that are not Hosted
Meetings ("Non-Hosted Meetings") with individuals (including those that are not
from sponsors) participating in the meetings program. These non-hosted meetings
are also based on a double opt-in process.
You will not need to miss any agenda sessions for Hosted or Non-Hosted meetings.
The reimbursement of up to $750 is conditioned upon (a) completing all of your
scheduled meetings, (b) submitting a short feedback survey, and (c) submitting
travel/hotel receipts following the event within our stated deadlines.
Click here for Terms & Conditions.
HOSTED RETAILERS & BRANDS (FREE)
Pronouns
*
He/Him
She/Her
They/Them
Prefer not to say
First Name
*
Last Name
*
Mobile Number
*
+1
Select Country Code
Work Email*
Alternate Email
(will be copied on all emails)
Your LinkedIn Profile URL
*
I have an Assistant(your Assistant will be copied on all emails)
Time Zone
(for display purposes only)
*
Select...
Country
*
Select...
Address
Suite, Apt, etc.
City/Locality
State/Region
Zip/Postal Code
--------------------------------------------------------------------------------
Your Organization
Organization Name*
Organization URL*
Describe your organization based on your primary job function
*
Select...
Retailer/Brand Vertical
(select up to 3)
*
Apparel & Accessories
Automotive
Beauty & Cosmetics
Beverage Alcohol
Consumer Electronics & Technology
CPG
Department Stores & Super Stores
Discount Stores
Entertainment, Media & Publishing
Flowers, Gifts & Specialty
Food CPG
Gas Station & Convenience Stores
Grocery
Health & Healthcare
Home & Furniture
Home Improvement
Luxury
Marketplace
Pet Products
Pharmacy & Drug Stores
Restaurants & QSR (Quick Service Restaurants)
Sporting & Recreational Equipment
Travel, Hotels & Hospitality
Toys, Books & Games
Other
What is the stage of your organization?
*
Select...
What is your total annual revenue?
*
Select...
What is your annual online revenue?
*
Select...
--------------------------------------------------------------------------------
Your Role
Job Title
*
Job Title Level
*
Select...
Job Function
(select up to 3)
*
Consulting & Advisory
Customer Experience
Data, Analytics & Insights
Digital & Ecommerce
Environmental, Social & Corporate Governance (ESG)
Executive Leadership & Board of Directors
Finance & Accounting
HR, Talent Acquisition & Workforce Management
Investing
Legal, Compliance & Risk
Logistics & Transportation (inc. Last-Mile)
Marketing, Advertising & Communications
Merchandising
Partnerships
Procurement & Vendor Management
Product Development & Management
Research, Content & Journalism
Sales, BD & Account Management
Store Operations
Strategy, Innovation & Transformation
Supply Chain, Operations & Fulfillment
Technology & IT
Other
Buying Responsibility: I am
(select all that apply)
*
The budget owner or final decision maker for ecommerce or retail solutions
buying decisions
Part of a team that makes ecommerce or retail solutions buying decisions
An influencer of ecommerce or retail solutions buying decisions
In procurement
Neither an influencer or buyer for ecommerce or retail solutions
Please list the relevant areas that you oversee or influence (with respect to
ecommerce or retail solutions)
*
0 / 500
--------------------------------------------------------------------------------
Your Hosted Ticket
I agree to participate in up to eight (8) 15-minute Hosted Program meetings (a
total of two hours)
I agree to the Groceryshop 2024 Hosted Program Terms for Retailers & Brands
I confirm that I am a retailer or brand (others do not qualify)
In addition to your requirement of up to eight (8) 15-minute onsite meetings
with participating sponsors ("Hosted Meetings"), would you like to participate
in non-Hosted Meetings?
These are meetings with individuals (including those not from sponsors)
participating in the meetings program. All meetings are double opt-in so that
they are useful to everyone and are based on your individual availability.
We recommend "Yes" to get the most out of the event
*
Yes, I'd like to get the most out of the event with Hosted and Non-Hosted
Meetings
No, I'll just do the required Hosted Meetings
To OPT OUT of the $750 Reimbursement opt out travel/hotel reimbursement for any
reason, check this box. If you want to receive the reimbursement, leave the box
unchecked.
--------------------------------------------------------------------------------
The following questions are for us to help you make the most of your time onsite
As a Retailer or Brand, you can join our Retailers & Brands Networking Dinner
Series (held on Mon, Oct 7), which we've designed to become a key new part of
the Groceryshop experience starting in 2024.
Check this box if you're interested in joining other retailers and brands for
amazing dinner experiences at top Las Vegas restaurants.
Topics of interest
(select all that apply)
Seizing New Opportunities in Retail Media
Enabling AI, Data and Technology Across the Organization
Reimagining Commercial Partnerships
Executing Seamless and Unified Retail Experiences
Exceptional Marketing and Brand Building Strategies
Building Profitable Ecommerce Businesses
Unlocking Efficiencies in Supply Chain and Store Operations
New Approaches to Product Assortment, Pricing and Promotion
Adapting to the Evolving Economic Climate
Embracing New Consumer Habits and Preferences
Your objectives for attending Groceryshop
(select all that apply)
Attend Sessions
Network and Make New Contacts
Source New Technology Solutions
Raise Capital
Build Brand Awareness
Gain Media Exposure
Generate New Clients and Leads
Source Investment Opportunities and Acquisitions
When's your birthday?
Do you have any accessibility requirements you would like Groceryshop to be
aware of to improve your onsite experience?
Do you have any dietary requirements?
(select all that apply)
Vegetarian
Vegan
Kosher
Halal
Gluten Intolerant
Non Lactose
Low Fat/Low Cholesterol/Low Calorie/Low Sodium
Diabetic
Allergy / Other
--------------------------------------------------------------------------------
Your Privacy
Hyve Group (Groceryshop's parent company) takes your privacy seriously – you can
read more about this in our Privacy Notice. We use your personal information to
provide the services you have requested from us and for other carefully
considered legitimate business purposes. This includes sending you marketing
communications and advertising about our events as well as information and
publications which we think would be of interest to you. You have the right to
object to this processing and, if you wish to do so, you can update your
preferences here. View a list of the events organised by Hyve Group here.
Groceryshop's technology provider, Personatech, processes data on behalf of
Groceryshop to deliver event technology services. I have read and agree to the
Personatech Terms of Use and acknowledge the Privacy Policy and Notice at
Collection.
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