Brittanni's Farmasi                                           Customer Account/ Sample Request Form
Please fill out for Farmasi Customer Account Thank you!!
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Email *
Are you a new or existing customer? *
First and Last Name* *
Email Address *
Date of Birth (mm/dd/yyyy) *
Mailing Address as appears on envelope (including city, state and zip) *
Phone Number *
SAMPLES PLEASE SELECT A FEW
I will send out (1-3) samples to you based on your choices and availability.
Stay Matte Foundation
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BB Cream
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CC Cream
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VFX Pro
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Liquid Concealer
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Primer
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Foot Care
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Massage Gel
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Hair Care
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Baby Care
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Age Reversist Skincare
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Men's Line
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Questions and comments
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