Casa de Fallon Beauty Order Form
SeneGence Distributor # 369435
Name (First, Last)
Address (include APT # is necessary)
City, State, Zip
Skin Type (for samples when available):
Normal to Dry
Normal to Oily
Oily to Acne
Please select the product(s) you'd like to purchase:
LipSense Starter Kit (1 color, 1 gloss, 1 remover) $55 +Tax *Required for first time users
LipSense Color $25 +Tax
LipSense Gloss $20 +Tax
Ooops! Remover $10 +Tax
Moisturizing Lip Balm $20 +Tax
ShadowSense $22 +Tax
LashSense $25 +Tax
LashSense + UnderSense $22 +Tax
BlushSense $30 USD +Tax
Climate Control $60 +Tax
Color Correcting Concealer $25 +Tax
Color Correcting Tinted Moisturizer $45 +Tax
EyeLuminator $55 +Tax
FOOPS! Remover $20 +Tax
MakeSense Anti-Aging Foundation $60 +Tax
MakeSense Original Foundation $50 + Tax
Self Tanning Bronzing Coconut Milk $50 +Tax
Traslucid Powder $50 + Tax
Skincare Regimen (Cleanser, Nighttime Moisturizer, Daytime Moisturizer) $140 +Tax
Please list the colors or regimen type you would like to receive with the quantity (ex. Bella, Blu Red, Normal to Dry) or desired Gift Certificate Amount:
Have your considered being a LipSense Distributor?
No, not for me.
Hmmm.... its crossed my mind but not the best time.
Yes, please reach out to me with more info!
Would you be interested in HOSTING a get together or party for rewards?
Yes, Facebook LIVE please!
Yes, in home please. Makeup, Friends and wine... sign me up!
No, thank you.
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