Professional products

For best service, please provide us with the information below.This information will be kept confidential. We will not sell or share this information with other parties.  Being a distributor or having distributor experience is not paramount in order to apply or qualify. All information provided by the distributor candidate will be reviewed and considered.

* Indicates required information


Date

Your Name *

Company Name *

Address 1

Address 2

City

State/Province:

Postal code

Country *

Phone *

Fax Number

E-mail Address *

Website

1. Are you a distributor for:
Cosmetics
Hair products
Skin care products
Not a distributor


2. Are you a distributor for:
Medical products
Hospital products
Not a distributor


3. How do you intend to distribute the products?
Outside sales associates
Mail order
Telemarketing calls
Television
Internet
Other

Please describe Other    



4. What medical, skin care, hair, or cosmetics lines are you currently distributing, if any.

5. What territory do you cover or would you like to cover? (city, state, country)

6. What markets do you currently distribute to or would you like to distribute to?
Skin care centers
Beauty salons
Spas
Doctors offices
Department stores
Pharmacies
Direct marketing to the consumer
Other

Please describe Other    



7. Approximately what volume (in US$) do you expect to purchase from Wilma Schumann every quarter (Winter, Spring, Summer and Fall) for your territory.

8. Are you a:
Corporation
Or an individual?



How long have you been in business?

Approximately how many employees do you currently have?

9. Approximately how many clients do you currently have?
10. What else can you tell us about your operation and experience? Please provide us with brochures, websites or any additional printed materials that you may have.


To contact us via standard mail, our address is:
Wilma Schumann Skin Care
4850 S.W. 72 Avenue
Miami, FL. 33155
U.S.A.
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