Ambassador Application Form

1
Name* This field is required.
First Name
Last Name
2
Mailing Address * This field is required.
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Phone Number
Please enter a valid phone number.
4
Email* This field is required.
example@example.com
Email Verified
Confirm Email
Email Verified
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5
Business NameIf applicable
6
Website or Social Media Handles* This field is required.(Instagram, TikTok, YouTube, etc.)
Website Link
Instagram Link
Facebook Link
YouTube Link
Tik Tok Link
7
Do you prefer to be contacted via Phone, Email, or Text?* This field is required.
Please Select
Please Select
Phone Call
Email
Text Message
8
Are you a returning client/student of Rapture Extensions /Lashes?* This field is required.
Yes
No
9
Which ambassador program are you applying for?* This field is required.
Influencer
Wholesaler
Both
10
What interests you most about becoming an RE Ambassador?* This field is required.Check all that apply
Discounted Products
Commission Earnings
Content Collaboration
Wholesale Opportunities
Other
11
How do you currently engage with your audience?* This field is required.Check all that apply
Social Media
Blogging
In-Person Sales
Online Store
Other
12
Have you ever promoted beauty products before?* This field is required.
YESNO
13
If yes, please provide examples or links.
Input Link
14
How many followers do you currently have on Instagram/TikTok/YouTube?* This field is required.Choose the closest range
0-5k
5k - 10k
10k - 50k
50k+
15
What is your target audience?* This field is required.Check all that apply
Beauty Enthusiasts
Hairstylists
Lash Technicians
Entrepreneurs
Other
16
Would you be open to participating in exclusive brand campaigns?* This field is required.
YESNO
17
Are you interested in receiving free or discounted products in exchange for content?* This field is required.
YESNO
18
If yes, indicate preferred products* This field is required.Select all that apply.
Extension Services
Strip Lashes
Hair Extensions
Apparel
Lash Tools/ Products
Lash Trainings / Classes
19
Do you belong or have influence to any groups and/or organizations?* This field is required.Select all that apply.
Fraternity / Sorority
Family / Friends / Word of Mouth
Non - Profits / Charity Groups
Facebook Groups
Political Parties
Other
20
Which RE products are you most interested in wholesaling?* This field is required.Check all that apply
Hair Extensions
Strip Lashes
Lash Extensions
Wigs
Haircare products
Lash Products
Apparel
21
How do you currently sell products?* This field is required.
In-person
Online
Both
22
If online, provide website/store link* This field is required.Insert website/store link
23
Would you be interested in private-label branding (custom packaging with your logo)?* This field is required.
YESNO
24
What is your estimated monthly purchase volume?
1-10 Units
10-50 Units
50+ Units
25
Are you willing to follow Rapture Extensions' ambassador guidelines and policies?* This field is required.
YESNO
26
Do you agree to provide promotional content?* This field is required.
YESNO
27
Do you agree to provide follow wholesale terms?* This field is required.
YESNO
28
Signature* This field is required.Acknowledging terms & conditions
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