Distributor Application Affair/Grandma’s™ OTC

Name *

First

Last

E-mail *

Phone *

Personal Address *

Company Name

Business Address

Business Phone

Business Email

How did you learn about Affair/Grandma's™? *

Which Market(s), Cities or States are you interested in representing Affair/Grandma's™ in? *

Please tell us what it is about Affair/Grandma's™ that interests you and why you would like to distribute the brand? *

How many hair care product lines do you currently distribute and what are their names? *

How do you plan to sell Affair/Grandma's™ Professional? (i.e. Home-Based Business, Internet, Retail Store, Salon, Beauty Supply, etc.) *

Have you had previous experience in selling other personal care products? If so, which products and for how long? *

If your Distributor Application is approved when would you be ready to start distributing? *

What is your projected monthly purchase volume?

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