Customer Registration Form
Fill out the form carefully for registration
Customer Name
*
First Name
Last Name
E-mail
*
example@example.com
Mobile Number
-
Area Code
Phone Number
Would you like text alerts for my LIVE sales on Facebook?
Yes please!
No thanks
Submit Application
Thank you for supporting my Boutique! I will only use your information to send you invoices when you purchase from me via Facebook LIVE!
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