stus24-registration.personatech.com Open in urlscan Pro
2600:1901:0:4895::  Public Scan

Submitted URL: https://hello.shoptalk.com/e3t/Ctc/2M+113/d120Wp04/VX823S3QQDMtW8y5m1x84_h5LVhPn1w59jhj1N3pwdFv9k468W8wM-gK6lZ3nlW7P9M4b43M...
Effective URL: https://stus24-registration.personatech.com/form/initiate?fId=OGQ4NDFmMzYtNmQ3Yy00MjI4LWJmYjEtNDZkZTkzODQ3YWI1&OTID=084aecfe-97f2-4d78-a783-...
Submission: On February 13 via api from ES — Scanned from ES

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 title="" class="dynamicLabel_primaryLabel">
            <p>Pronouns</p>
          </span><span class="dynamicLabel_asterisk"></span></label></label><span class="form_label--required">*</span></label>
    <div class="radioBtnGroup radioBtnGroup--horizontal">
      <div class="radioBtn"><label><input type="radio" name="d5fc0cbb-f0da-4f89-a83f-f5aa0de6fd7c" 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="d5fc0cbb-f0da-4f89-a83f-f5aa0de6fd7c" 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="d5fc0cbb-f0da-4f89-a83f-f5aa0de6fd7c" 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="d5fc0cbb-f0da-4f89-a83f-f5aa0de6fd7c" 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="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>First Name</p>
          </span><span class="dynamicLabel_asterisk"></span></label></label><span class="form_label--required">*</span></label>
    <div class="inputBox"><input type="text" name="da0c4d9e-73dc-4f77-b254-76e49320f36a" data-testid="da0c4d9e-73dc-4f77-b254-76e49320f36a" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Last Name</p>
          </span><span class="dynamicLabel_asterisk"></span></label></label><span class="form_label--required">*</span></label>
    <div class="inputBox"><input type="text" name="c50182c5-3536-4664-a8d0-cacd50276ab8" data-testid="c50182c5-3536-4664-a8d0-cacd50276ab8" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Mobile Number</p>
          </span><span class="dynamicLabel_asterisk"></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">
                <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 type="text" name="b4b31f57-1e6e-4db8-aa9c-73521a0e08ac" data-testid="b4b31f57-1e6e-4db8-aa9c-73521a0e08ac" value=""></div>
    </div>
  </div>
  <div class="transformToLowerCase form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">Work Email</span><span
            class="dynamicLabel_asterisk"></span></label></label><span class="form_label--required">*</span></label>
    <div class="transformToLowerCase inputBox"><input type="text" name="27cf2508-6ba4-42ce-b251-a58e08da34c1" data-testid="27cf2508-6ba4-42ce-b251-a58e08da34c1" value=""></div>
  </div>
  <div class="transformToLowerCase form_item"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Alternate Email</p>
          </span><span title=""
            class="form_label_additionalNote"><i><p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;(will be copied on all emails)&quot;}" data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">(will be copied on all emails)</span></p></i></span></label></label></label>
    <div class="transformToLowerCase inputBox"><input type="text" name="24ba9884-b327-4a99-9941-15f41dbf3cfc" data-testid="24ba9884-b327-4a99-9941-15f41dbf3cfc" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Your LinkedIn Profile URL</p>
          </span><span class="dynamicLabel_asterisk"></span></label></label><span class="form_label--required">*</span></label>
    <div class="inputBox"><input type="text" name="2cb1d1ac-5d03-4a89-95c9-98c23c0e655b" data-testid="2cb1d1ac-5d03-4a89-95c9-98c23c0e655b" value=""></div>
  </div>
  <div class="form_item form_item--fullWidth">
    <div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="ce6d8562-58f0-4224-9ce2-c57a2112de35"><b></b><span class="checkbox_text"><label class="dynamicLabel"><label><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></label></label> </span></label></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><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></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="f2f4a59f-ff2b-4f01-86bb-61d73dc07a80" 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" 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="f2f4a59f-ff2b-4f01-86bb-61d73dc07a80" type="hidden" value="">
      </div>
    </div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Country</p>
          </span><span class="dynamicLabel_asterisk"></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="8547afa6-4232-4032-8a39-e74fb9877fe7" 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" 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="8547afa6-4232-4032-8a39-e74fb9877fe7" type="hidden" value="">
      </div>
    </div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Address&quot;}"
                data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">Address</span>
            </p>
          </span></label></label></label>
    <div class="inputBox"><input type="text" name="f85ec50d-acce-40c0-8200-50ab45cfd121" data-testid="f85ec50d-acce-40c0-8200-50ab45cfd121" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Suite, Apt, etc. &quot;}"
                data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">Suite,
                Apt, etc. </span></p>
          </span></label></label></label>
    <div class="inputBox"><input type="text" name="d9f717ba-2d5c-4f2c-a49d-1fa64d56fd7d" data-testid="d9f717ba-2d5c-4f2c-a49d-1fa64d56fd7d" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;City/Locality&quot;}"
                data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">City/Locality</span>
            </p>
          </span></label></label></label>
    <div class="inputBox"><input type="text" name="d4187ba1-7785-4041-aa6b-fefac4de39b0" data-testid="d4187ba1-7785-4041-aa6b-fefac4de39b0" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;State/Region&quot;}"
                data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">State/Region</span>
            </p>
          </span></label></label></label>
    <div class="inputBox"><input type="text" name="b43e821e-daa5-477a-bd19-d7918dff0cc3" data-testid="b43e821e-daa5-477a-bd19-d7918dff0cc3" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Zip/Postal Code&quot;}"
                data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">Zip/Postal
                Code</span></p>
          </span></label></label></label>
    <div class="inputBox"><input type="text" name="593e321a-4e3e-42f8-b907-138284486c15" data-testid="593e321a-4e3e-42f8-b907-138284486c15" 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 title="" class="dynamicLabel_primaryLabel">
            <p>
              <b><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Your Organization&quot;}" data-sheets-userformat="{&quot;2&quot;:29099,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9,&quot;17&quot;:1}">Your Organization</span></b>
            </p>
          </span></label></label></label></div>
  <div class="form_item"><label for="a28f096a-94d0-496b-b950-5140312a65e3" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">Organization Name</span><span
            class="dynamicLabel_asterisk"></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="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">Organization URL</span><span
            class="dynamicLabel_asterisk"></span></label></label><span class="form_label--required">*</span></label>
    <div class="inputBox"><input type="text" name="9797babd-93ac-4271-9174-d865d5ba75e4" data-testid="9797babd-93ac-4271-9174-d865d5ba75e4" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Describe your organization based on your primary job function</p>
          </span><span class="dynamicLabel_asterisk"></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="01a89b5d-dcc4-4197-8d66-69d4062d693b" 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" 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="01a89b5d-dcc4-4197-8d66-69d4062d693b" 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 title="" class="dynamicLabel_primaryLabel">
                <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Retailer/Brand Vertical&quot;}"
                    data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">Retailer/Brand
                    Vertical</span></p>
              </span><span class="dynamicLabel_asterisk"></span><span title=""
                class="form_label_additionalNote"><i><p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;(select up to 3)&quot;}" data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">(select up to 3)</span></p></i></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="2297cafe-0efc-4fff-9b56-f53bea85cbcc"><b></b><span class="checkbox_text">Apparel &amp; Accessories </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="80285445-566a-476a-b877-a887f0da1401"><b></b><span class="checkbox_text">Automotive </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="58f0b194-7d66-4c04-9f75-5df99d1075ac"><b></b><span class="checkbox_text">Beauty &amp; Cosmetics </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6ad28d60-ba5a-43a8-af18-55ce9ac224c6"><b></b><span class="checkbox_text">Beverage Alcohol </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1a30472f-426a-41cd-bcfc-9468a3605dca"><b></b><span class="checkbox_text">Consumer Electronics &amp; Technology </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="13f22602-42fe-432d-9c0a-592ef17f8e4b"><b></b><span class="checkbox_text">CPG </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="8389c47e-6880-45c3-b5b2-b7f4fd255492"><b></b><span class="checkbox_text">Department Stores &amp; Super Stores </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="5ad71360-37ee-4047-a93e-d0ce3807e256"><b></b><span class="checkbox_text">Discount Stores </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="765df635-c8c1-4137-bb22-cd54ff9d3f98"><b></b><span class="checkbox_text">Entertainment, Media &amp; Publishing </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="fcfb6b1c-1fab-412a-8a36-430d6f7f496c"><b></b><span class="checkbox_text">Flowers, Gifts &amp; Specialty </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6be5ba63-a393-4174-9f9b-5877b2ceb87e"><b></b><span class="checkbox_text">Food CPG </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="c1096900-569d-4223-a93c-b18df4816e7a"><b></b><span class="checkbox_text">Gas Station &amp; Convenience Stores </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="c4c2450e-240e-47fb-89fb-1cbc998c3438"><b></b><span class="checkbox_text">Grocery </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="938bdd66-37c0-4a44-80dc-d97e27028c33"><b></b><span class="checkbox_text">Health &amp; Healthcare </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="4e8ce7d3-05fd-40f5-821f-cc21fc981554"><b></b><span class="checkbox_text">Home &amp; Furniture </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6c529838-a701-44a8-878f-77cc2d860c63"><b></b><span class="checkbox_text">Home Improvement </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="792e2114-8c3f-4eff-9980-60f04f1e5aee"><b></b><span class="checkbox_text">Luxury </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="bb0746df-3daf-4ea3-8839-79cba606fbe4"><b></b><span class="checkbox_text">Marketplace </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="c8518c13-5f62-46fa-8c8f-f421f8413626"><b></b><span class="checkbox_text">Pet Products </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="94b11fbb-8f3f-48d4-8e6c-965d8670360e"><b></b><span class="checkbox_text">Pharmacy &amp; Drug Stores </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="5d0eac85-b130-4406-bbc8-2d38f4f639c3"><b></b><span class="checkbox_text">Restaurants &amp; QSR (Quick Service Restaurants) </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="0ca5408d-0ef4-453e-a7ac-a276bfa8264b"><b></b><span class="checkbox_text">Sporting &amp; Recreational Equipment </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="95056c01-0601-49f8-a737-7840bb3915dd"><b></b><span class="checkbox_text">Travel, Hotels &amp; Hospitality </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6e7c7bce-93c1-4ccc-bd42-227749b26d3e"><b></b><span class="checkbox_text">Toys, Books &amp; Games </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="af4c7014-a4fe-4f44-b544-e62fe092494c"><b></b><span class="checkbox_text">Other </span></label></div>
      </div>
    </div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;What is the stage of your organization?&quot;}"
                data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">What
                is the stage of your organization?</span></p>
          </span><span class="dynamicLabel_asterisk"></span></label><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">
              <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></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="53864d68-61cf-48c9-b561-3d3aa648fb4e" 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" 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="53864d68-61cf-48c9-b561-3d3aa648fb4e" 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 title="" class="dynamicLabel_primaryLabel">
            <p>
              <b><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Your Role&quot;}" data-sheets-userformat="{&quot;2&quot;:29099,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9,&quot;17&quot;:1}">Your Role</span></b>
            </p>
          </span></label></label></label></div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Job Title</p>
          </span><span class="dynamicLabel_asterisk"></span></label></label><span class="form_label--required">*</span></label>
    <div class="inputBox"><input type="text" name="e4189f1e-e603-4eec-aaf9-b0b653e3eae5" data-testid="e4189f1e-e603-4eec-aaf9-b0b653e3eae5" value=""></div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel dynamicLabel--required"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>Job Title Level</p>
          </span><span class="dynamicLabel_asterisk"></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="f1e6a67d-14ae-4a7a-b208-d6ab778fe849" 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" 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="f1e6a67d-14ae-4a7a-b208-d6ab778fe849" 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 title="" class="dynamicLabel_primaryLabel">
                <p>Job Function</p>
              </span><span class="dynamicLabel_asterisk"></span><span title=""
                class="form_label_additionalNote"><i><p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;(select up to 3)&quot;}" data-sheets-userformat="{&quot;2&quot;:12715,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">(select up to 3)</span></p></i></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="4f1164c5-8a7a-49ff-8027-138572edcc02"><b></b><span class="checkbox_text">Consulting &amp; Advisory </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="db99b7af-97b6-4a1f-b4a5-d022df3259c4"><b></b><span class="checkbox_text">Customer Experience </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="cd7a8e7a-b9ac-44e1-b10d-f352ff85316f"><b></b><span class="checkbox_text">Data, Analytics &amp; Insights </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1cf894ee-b37f-456b-9d8b-2e4dc01c3346"><b></b><span class="checkbox_text">Digital &amp; Ecommerce </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="05ba522d-04f0-4106-888f-229de075d4e6"><b></b><span class="checkbox_text">Environmental, Social &amp; Corporate Governance (ESG) </span></label>
        </div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="d3a6ab75-179a-49a1-a1bf-526bff179cb1"><b></b><span class="checkbox_text">Executive Leadership &amp; Board of Directors </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1c855dc1-1af7-4353-81d7-8dede01d627e"><b></b><span class="checkbox_text">Finance &amp; Accounting </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6ecc62c2-cc6a-41b6-8fa4-e4403af37410"><b></b><span class="checkbox_text">HR, Talent Acquisition &amp; Workforce Management </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="f9dae8ae-7f72-483d-82c1-e34678e057f6"><b></b><span class="checkbox_text">Investing </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="86d770f0-4b80-4ddc-b80d-402c12cf2308"><b></b><span class="checkbox_text">Legal, Compliance &amp; Risk </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="aaef4402-19e8-4654-b5bf-641c350b3043"><b></b><span class="checkbox_text">Logistics &amp; Transportation (inc. Last-Mile) </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="de0ac9d4-fe95-474f-ab93-3994d28266d1"><b></b><span class="checkbox_text">Marketing, Advertising &amp; Communications </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="aa21a746-819e-4e16-870d-b0059a266ea4"><b></b><span class="checkbox_text">Merchandising </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="9951f084-9846-45be-9691-2ed98d8b845e"><b></b><span class="checkbox_text">Partnerships </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="90f7358d-a32a-4434-9ba0-810e06ffbd3d"><b></b><span class="checkbox_text">Procurement &amp; Vendor Management </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="f2d28617-1098-44bf-ad11-b08fc3402324"><b></b><span class="checkbox_text">Product Development &amp; Management </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="2a4f37ad-9af4-4957-a90f-849b5a8d845f"><b></b><span class="checkbox_text">Research, Content &amp; Journalism </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="e326ae66-1f50-421c-8cbf-5062707b4d01"><b></b><span class="checkbox_text">Sales, BD &amp; Account Management </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="214481a3-14ca-49e0-a0af-62bb8740df8e"><b></b><span class="checkbox_text">Store Operations </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="9ece0918-a784-47e3-87a1-42eee5628948"><b></b><span class="checkbox_text">Strategy, Innovation &amp; Transformation </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="9d19734f-af2e-4164-a7de-30d64ae0a5c0"><b></b><span class="checkbox_text">Supply Chain, Operations &amp; Fulfillment </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="65434423-c55a-4d68-a3b5-859b5a7e5c56"><b></b><span class="checkbox_text">Technology &amp; IT </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="0eb37d2a-c66a-4512-bbf4-c1512822d79e"><b></b><span class="checkbox_text">Other </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 title="" class="dynamicLabel_primaryLabel">
            <p>
              <b><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;The following questions are for us to help you make the most of your time onsite&quot;}" data-sheets-userformat="{&quot;2&quot;:29118,&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;5&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;7&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9,&quot;17&quot;:1}">The following questions are for us to help you make the most of your time onsite</span></b>
            </p>
          </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="6a35f8c5-fae4-4c4a-a1c9-4657937e0272"><b></b><span class="checkbox_text"><label class="dynamicLabel"><label><span title=""
                class="dynamicLabel_primaryLabel">
                <p><b>As a Retailer or Brand, you can join our Retailers &amp; Brands Networking Dinner Series (held on Mon, Mar 18), which we've designed to become a key new part of the Shoptalk experience starting in 2024. </b></p>
                <p>The pre-event sign up process will be automated, and we'll be in touch with details. Check this box if you're interested in joining other retailers and brands for amazing dinner experiences at top Las Vegas restaurants.</p>
              </span></label></label> </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 title="" class="dynamicLabel_primaryLabel">
                <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Topics of interest&quot;}"
                    data-sheets-userformat="{&quot;2&quot;:12735,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;5&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;7&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">Topics
                    of interest</span></p>
              </span></label></label></label></div>
      <div class="checkboxGroup_wrapper">
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="184c6976-0560-4364-ab24-932a810a1697"><b></b><span class="checkbox_text">Groundbreaking AI Applications in Retail </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="bfcadf70-eae3-4d2e-8e81-a554455e09ba"><b></b><span class="checkbox_text">Best-in-Class Unified Shopping Experiences </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="9c32f02f-d609-4ac2-bba9-2223d6dd89b4"><b></b><span class="checkbox_text">Navigating Changing Industry Relationships </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="42cd42af-c742-4bc2-8021-a94d9cb8cc24"><b></b><span class="checkbox_text">Future of Brands and Brand-Building </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="51047434-0fc3-4985-beb9-fed982da4398"><b></b><span class="checkbox_text">Next-Gen Customer Journeys: Marketing and Acquisition </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="3bac0d40-0896-49de-a982-2cf019e8bb26"><b></b><span class="checkbox_text">Next-Gen Customer Journeys: Loyalty, Engagement and Retention
            </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="fb04aac3-5121-4306-906f-e3007df35b94"><b></b><span class="checkbox_text">Exceptional Retail Experiences: Seamless Stores </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6ee04ca2-9ac9-4759-bbeb-1064365b47f0"><b></b><span class="checkbox_text">Outstanding Ecommerce and Digital Shopping Experiences </span></label>
        </div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="d851edd2-d278-4cda-9274-6c6450d48eaa"><b></b><span class="checkbox_text">Forward-Looking Merchandising and Assortment Strategies </span></label>
        </div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="ab3acb59-071f-4e7c-b59a-e20cb4511982"><b></b><span class="checkbox_text">Operations and Supply Chain Advances </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="9dc66ae4-b370-406c-a777-fc247ef61514"><b></b><span class="checkbox_text">Cutting-Edge Retail Technologies </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="ebf335e0-5ba2-4f13-8d61-ec94d99f6c9e"><b></b><span class="checkbox_text">Organizational Agility and Resilience </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="8b5f01b0-aa95-4c35-93c2-1bbfcdb7aadf"><b></b><span class="checkbox_text">Inspiring Global Retail Experiences and Innovations </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="187819fc-3e0d-4065-b6c2-c265788a19ae"><b></b><span class="checkbox_text">Understanding the Changing Consumer </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="6712e7a3-20d0-4d13-9108-709436b2e9f3"><b></b><span class="checkbox_text">Actionable Research and Market Insights </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 title="" class="dynamicLabel_primaryLabel">
                <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Your objectives for attending Shoptalk&quot;}"
                    data-sheets-userformat="{&quot;2&quot;:13247,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;5&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;7&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;11&quot;:4,&quot;12&quot;:0,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9}">Your
                    objectives for attending Shoptalk</span></p>
              </span></label></label></label></div>
      <div class="checkboxGroup_wrapper">
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="b6e584aa-626a-4156-a9fe-d4caa25f28f2"><b></b><span class="checkbox_text">Attend Sessions </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="4e07cb07-2cff-4516-b75e-b0fc31aad7f6"><b></b><span class="checkbox_text">Network and Make New Contacts </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1ec4b145-e893-4936-9a13-9e0871ea5a5d"><b></b><span class="checkbox_text">Source New Technology Solutions </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1a835807-e0ad-48c1-8834-f8cd99e61bfc"><b></b><span class="checkbox_text">Raise Capital </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="f8487990-bfa0-4090-9e80-ae96c3ba4c22"><b></b><span class="checkbox_text">Build Brand Awareness </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="24b94c8e-0d4e-40fb-a4ea-7c0fe7a6faf9"><b></b><span class="checkbox_text">Gain Media Exposure </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="92b9c665-94dd-4698-bc8f-8ac1e81fff48"><b></b><span class="checkbox_text">Generate New Clients and Leads </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="1e04df68-586c-43d7-8d83-35e150f1dc45"><b></b><span class="checkbox_text">Source Investment Opportunities and Acquisitions </span></label></div>
      </div>
    </div>
  </div>
  <div class="form_item"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p>When's your birthday?</p>
          </span></label></label></label>
    <div class="inputBox"><input type="text" name="fbeca629-3e11-4a38-a5b4-1d7fb1006b24" data-testid="fbeca629-3e11-4a38-a5b4-1d7fb1006b24" placeholder="e.g., Jan-01" value=""></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 title="" class="dynamicLabel_primaryLabel">
                <p>Do you have any dietary requirements we should know about?</p>
              </span><span title="" class="form_label_additionalNote"><i><p>(select all that apply)</p></i></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">Vegetarian </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="VEGAN"><b></b><span class="checkbox_text">Vegan </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="KOSHER"><b></b><span class="checkbox_text">Kosher </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="HALAL"><b></b><span class="checkbox_text">Halal </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="GLUTEN_INTOLERANT"><b></b><span class="checkbox_text">Gluten Intolerant </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="NON_LACTOSE"><b></b><span class="checkbox_text">Non Lactose </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="LOW_CONTENT"><b></b><span class="checkbox_text">Low Fat/Low Cholesterol/Low Calorie/Low Sodium </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="DIABETIC"><b></b><span class="checkbox_text">Diabetic </span></label></div>
        <div class="checkbox checkbox--md"><label><input class="checkbox_input" type="checkbox" name="ALLERGY_OTHER"><b></b><span class="checkbox_text">Allergy / Other </span></label></div>
      </div>
    </div>
  </div>
  <div class="form_item form_item--fullWidth">
    <div class="checkbox checkbox--lg"><label><input class="checkbox_input" type="checkbox" name="fe737974-d53b-4967-ac62-bdb8c212b718"><b></b><span class="checkbox_text"><label class="dynamicLabel"><label><span title=""
                class="dynamicLabel_primaryLabel">
                <p>Do you have any access requirements?</p>
              </span></label></label> </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 title="" class="dynamicLabel_primaryLabel">
            <p>
              <b><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;Your Privacy&quot;}" data-sheets-userformat="{&quot;2&quot;:29375,&quot;3&quot;:{&quot;1&quot;:0},&quot;4&quot;:{&quot;1&quot;:2,&quot;2&quot;:16777215},&quot;5&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;6&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;7&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;8&quot;:{&quot;1&quot;:[{&quot;1&quot;:2,&quot;2&quot;:0,&quot;5&quot;:{&quot;1&quot;:2,&quot;2&quot;:0}},{&quot;1&quot;:0,&quot;2&quot;:0,&quot;3&quot;:3},{&quot;1&quot;:1,&quot;2&quot;:0,&quot;4&quot;:1}]},&quot;10&quot;:0,&quot;12&quot;:0,&quot;15&quot;:&quot;Calibri&quot;,&quot;16&quot;:9,&quot;17&quot;:1}">Your Privacy</span></b>
            </p>
          </span></label></label></label></div>
  <div class="form_item form_item--fullWidth"><label for="" class="form_label" title=""><label class="dynamicLabel"><label><span title="" class="dynamicLabel_primaryLabel">
            <p><a href="https://hyve.group/Home" target="_blank" rel="noopener">Hyve Group</a> (Shoptalk'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 <a href="mailto:data.privacy@hyve.group" target="_blank" rel="noopener">update your preferences here</a>.
              <a href="https://hyve.group/Events" target="_blank" rel="noopener">View a list of the events organised by Hyve Group here</a>.</p>
          </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="15c293c7-6af2-4e79-9fd3-61378e6bd2d5"><b></b><span class="checkbox_text"><label class="dynamicLabel dynamicLabel--required"><label><span title=""
                class="dynamicLabel_primaryLabel">
                <p><span data-sheets-value="{&quot;1&quot;:2,&quot;2&quot;:&quot;I have read and agree to the Personatech Terms of Use [LINK] and acknowledge the Privacy Policy and Notice at Collection [LINK].&quot;}"
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March 17-20, 2024
Mandalay Bay, Las Vegas


RETAILERS & BRANDS (PAID)

 * Details
 * Payment

Pronouns

*
He/Him
She/Her
They/Them
Prefer not to say

First Name

*


Last Name

*


Mobile Number

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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)

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Country

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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...


--------------------------------------------------------------------------------

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

--------------------------------------------------------------------------------

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, Mar 18), which we've designed to become a key new part of
the Shoptalk experience starting in 2024.

The pre-event sign up process will be automated, and we'll be in touch with
details. 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

Groundbreaking AI Applications in Retail
Best-in-Class Unified Shopping Experiences
Navigating Changing Industry Relationships
Future of Brands and Brand-Building
Next-Gen Customer Journeys: Marketing and Acquisition
Next-Gen Customer Journeys: Loyalty, Engagement and Retention
Exceptional Retail Experiences: Seamless Stores
Outstanding Ecommerce and Digital Shopping Experiences
Forward-Looking Merchandising and Assortment Strategies
Operations and Supply Chain Advances
Cutting-Edge Retail Technologies
Organizational Agility and Resilience
Inspiring Global Retail Experiences and Innovations
Understanding the Changing Consumer
Actionable Research and Market Insights

Your objectives for attending Shoptalk

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 dietary requirements we should know about?

(select all that apply)

Vegetarian
Vegan
Kosher
Halal
Gluten Intolerant
Non Lactose
Low Fat/Low Cholesterol/Low Calorie/Low Sodium
Diabetic
Allergy / Other

Do you have any access requirements?

--------------------------------------------------------------------------------

Your Privacy

Hyve Group (Shoptalk'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.

Shoptalk's technology provider, Personatech, processes data on behalf of
Shoptalk 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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