Partner Application

First Name *

Last Name *

Company Name *

Email *

Password

Phone *

Country * United StatesCanada

Address 1 *

Address Line 2 (optional)

City *

State *

Postcode *

Professional / Business License Number *

Website (optional)

Type of Business? * Salon/SpaIndependent Spa ProfessionalBeauty BoutiqueWellness StudioMed SpaOther

Number Of Employees (optional) 12 - 56 - 1011 - 2021 +

Sales Tax Exempt? (If yes then you must submit sales tax certificate upon first order) * NoYes

Sales Tax ID (optional)

Are there any specific product categories you are interested in? (optional)

What treatment lines do you currently carry? (optional)

How Did You Hear About Us? (optional)

By checking the box you acknowledge that you have read and agree to the Skincare Treatment Agreement *I agree