Real Women Talking - Nominate a Real Woman

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Positive Selfishness

Question of the Month

* Required information.

Your Name:
*

City, State of residence:

E-Mail:
*

About the woman you are nominating:

Nominee’s Name:
*

City, State of residence:
*

E-Mail:
*

Website:

Marital Status: (i.e. single, married, separated, divorced)

If she has children, please answer the following:

Number of children:

Ages:

	Stay-at-home Mom.
	Working outside the home. If yes, please briefly describe type of work and whether work is full-time, part-time, telecommute, job-share, etc.

	“Hybrid Mom.” Self-employed, run a business from home, freelance, etc. Please explain:

How did you hear of us?

Why do you think your nominee should be featured in a future “Focus on a Real Woman Talking”?

May we contact you for additional information? Yes No

Thank you for your time!

If you had
an extra hour
in your day,
how would you
spend it?

We are busy researching and writing a book on
self-care (and encouraging mothers to find the time to put themselves on their growing "to-do" lists).
Please answer our Positive Selfishness Questionnaire.

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