Enjoy A Facial in the Privacy of Your Home, Or, Let's Have An Online Skin Care Class!!!

Complete all the questions below as best as you can
And I will prepare a beauty profile for you and send you the products to try!!!

After answering all questions to the best of your ability, and be sure to include you name, email address, telephone number, and fax number if you have one.  I will prepare a profile for you!!! 

Your Name:          

Phone (day):                                                                        (Eves):


Marital Status:                                                    Email: 

My current skin care routine consists of the following products:

My natural hair color is: 

My natural eye color is: 

My skin tone is: 

For my dominant ethinic heritage, my skin color is:

My dominant ethinic heritage is: 

I would describe my skin type as: 

My age is: 

This statement most closely resembles my lifestyle: 

Hostess Name, or, Your Name: 

My Consultant is:  

Please be sure to complete in its entirety and include your mailing address below so that you can receive your facial in the mail!!!  ENJOY!!!
Address cont.:
City, State & Zipcode: