DELUXE SAMPLE PACK REQUEST FORM
By completing this form, you are RSVPing to attend the Facebook Virtual Scent Social as scheduled and asking that a package of Scentsy samples be mailed out to you.
Your Host's Name (who invited you)
*
First Name
Last Name
Your Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell Phone Number
*
Format: (000) 000-0000.
Facebook Name
example@example.com
Do you currently use Scentsy products?
*
YES
NO
What type of smells do you enjoy?
Clean/Fresh
Fruity
Citrus
Bakery
Floral
Spice
Woods
List any products you have not tried or would like to try or that you would like to see in the Live Demo.
Do you have kids?
YES
NO
Do you have pets?
Cat
Dog
Other
No pets
Do you have a couple of friends who may need bulbs, wax bars, or other scented goodies?
YES
NO
MAYBE (tell me more)
Would you like to be spoiled with free and half-price scented goodies for yourself?
YES
NO
MAYBE (tell me more)
Do you know anyone who would be interested in earning extra money and/or free vacations?
YES
NO
MAYBE (tell me more)
Submit
Should be Empty: