Harley Wax Distributor Form
Want to become a Harley Waxing Distributor? Fill in the application form below and we will contact you for further details.
Email address *
Contact Details
Please provide your contact information.
Company Name
Your answer
Full Name
Your answer
Email Address
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Physical Address
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Country
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Contact Number, with dial codes
Your answer
Your Business
Tell us more about your business and personal skills.

Your Skills. Are you a therapist, if so what services do you offer?
Your answer
Education. Provide a brief background on your qualification
Your answer
Salon Name
Your answer
Salon Address
Your answer
Do you own more than one Salon If so, please provide a brief description
Your answer
Date Established. When was your salon established?
MM
/
DD
/
YYYY
How many therapists?
Your answer
Trade shows. What is the last trade show you attended, and its date?
Your answer
Are you currently using Harley Wax?
What waxing treatments do you practice?
More Details. Tell us more about your current business
Your answer
Distributor Information
Tell us more about your distribution business.
Are you currently a distributor for any other health and beauty products?
Your answer
How many Spas or Salons do you service?
Your answer
Territory & Country. What areas would you like to cover as a Harley Waxing distributor?
Your answer
Why do you want to become a distributor?
Your answer
A copy of your responses will be emailed to the address you provided.
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