New Customer Registration Form

Linker Application
Full Name*

First NameLast Name
Best Number to Reach You*
Email*
example@example.com
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What area are you wanting to do permanent jewelry in? Please provide zip codes.*
Do you have another job? If so, what do you do?*
How many hours a week are you wanting to commit to permanent jewelry events?*
When would you like to get started?*
Do you have any Lakuna Jewelry from us?*

YesNo
Why do you want to be a linker for Lakuna Links?*
Is there anything else you would like us to know about how awesome you are?*
We CAN'T wait to talk with you soon! ⚡️
Should be Empty:

Linker Application