Sign in to your Google account to fill out this form
This form contains features which require sign in. Your identity will not be revealed.
Responses cannot be edited
Your Luscious Lips VIP Monthly Club
You will be automatically be charged $25 once a month for a hand chosen LipSense lip color!
What color families are your favorite?
Do you have a wish list list?
Which day would you like to be charged for your monthly color?
1st of the Month
15th of the Month
Do you consent to be automatically charged on the day you have chosen above? (You may cancel any time by emailing me)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service