Wholesale

Elina Fedatova, Elina Skin Care Owner

Application for Product Sales & Training

Fields with a (*) are required.

*Name:
Title:
*Company:
*Address:
*City:
*State:
*Zip Code:
*Telephone:
Fax:
*Email:
Website:
*Type of Business: (e.g. Plastic Surgeon’s Office, Spa, Salon, etc.)
*Years in Business:
*Number of Employees:
*Do you employ licensed aestheticians?:	Yes No If yes how many?
*What services do you provide?:
Are you interested in our retail line, our professional line, or both?:
*Are you interested in training?:	Yes No If yes, how many employees would attend?
*Do you currently sell another skin care product line?:	Yes No If yes, which one? If yes, and if selected by Charlene, do you intend to phase out your current line or continue to sell both? Yes No
Why do you want to carry Elina’s Elite line?*
Please list at least three credit references:*	Reference #1 Reference #2 Reference #3 Reference #4 Reference #5
Additional Comments or Questions:

Natural • Transdermal • Bioenergized
Vibrational Harmony of Nature • Elina Skin Care Representative
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