Eufora Salon Services: Customer Application

Stylist Name *

First Name Last Name

Stylist Mobile Phone Number *

Area Code Phone Number

Stylist Email *

example@example.com

Stylist Instagram

@example

Stylist Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Salon Name *

Salon Owner *

Salon Email *

example@example.com

Salon Website

www.example.com

Salon Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Salon Distributor *

Other Distributor

Do you currently use Eufora in your salon *

Yes No

Desired Partnership Level *

Eufora Friend: Independent Stylist Using Eufora Haircare or EuforaColor Evolve Salon: Non-Exclusive Salon Use (2-3 Brands) Experience Salon: Eufora Haircare Retail Exclusive Only Exclusive Salon: Eufora Haircare & EuforaColor (Full Eufora representation)

All Retail Brands Carried *

All Color Brands Used *

I am most interested in receiving communication regarding *

Product Innovation & News Technical Education Opportunities Business Intelligence Consulting Salon Lifestyle + Wellness Tips

How did you hear about Eufora?

Please upload a copy of your Resale Certificate.

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