First Name:             

    Last Name:

    Company Name:

    Type of Business:

    Federal Tax ID # or Federal EIN #:   Mandatory. Sorry no exceptions. If you prefer you can fax a copy of your id #,

                                                                                                    along with this completed form and a copy of your business license to (541) 688-2222.

    State Resale #, State License or Registration #:   Mandatory. Sorry no exceptions.

    Street Address:

    City:

    State/Province:

    Zip Code:

    Country:

    Business Phone:

    Home or Cell Phone:

    Fax:

    E-mail: Please make sure your email provider will accept email from bonsanteskincare.com

                                               Email is how we will send our price list, etc. We're sorry, but we do not accept hotmail addresses.

    Web Site:

    Are you interested in products with your business name and logo? (Yes or No).

    Please list the quantities of each product that you may wish to purchase?

    Will you be packaging your own products? (Yes or No).

    What brand(s) of skin care do you currently sell?  

    What brand(s) of mineral makeup do you currently sell? 

    Are you currently involved in formulating or manufacturing personal care products?

   (Please answer yes or no, if you leave this area blank, we will not be able to assist you in any way)

    Are you associated in some way with a manufacturer? Please describe below.

    List your comments. (For example, what type of products are you interested in or how can we be helpful?        

    How did you first hear about us? (Select One)           

           Web Search Referral Advertisement - Web Advertisement - Print Other (Please list below)  

    Search engine used?

    What key words did you use if this was an internet search?

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