New Customer Form
Please take a moment to completely fill out this form so I can make your SCENTSY experience personalized and REWARDING!
Customer Full Name
*
First Name
Last Name
Billing/Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Best Method of Contact
*
Phone
Text Message
Email
Birthdate
*
/
Month
/
Day
Year
Date
Are you new to the Scentsy Experience?
*
Yes
No
How did you find me?
*
Would you like to receive a copy of the current season Scentsy Catalog?
*
Yes
No
What Scentsy products are you MOST interested in (please specify)?
*
Which of these Scentsy Scent Families interest you? Please pick as many as you want!
*
Bakery (An ode to edible, delectably sweet goodies. Includes notes like vanilla, caramel, cocoa and pie crust)
Citrus (Classic to sparkling citrus blends. Includes notes like orange, grapefruit, mandarin and lemon)
Floral (Fantasy to real-life floral bouquets. Includes notes like hibiscus, lilac, rose and freesia)
Fresh (From the spa to the beach to a sunny meadow stroll. Includes notes like fresh air, linen, lavender, mint and just-cut grass)
Fruity (Ripe, fresh-squeezed and always sweet. Includes notes like pineapple, peach, strawberry and apple)
Spice (Give a sense of warmth and comfort. Includes notes like cinnamon, cardamom and black pepper)
Woods (Full-bodied and masculine. Includes notes like cedar, sandalwood, pine and leather)
Would you like to enroll in my Scentsy Birthday Club (you will receive a Scentsy gift of your choice during your birthday month)?
*
Yes
No
If you selected YES, what Scentsy product would you MOST like to receive on your special day?
*
Deluxe Wax Bar Sample (your choice of scent)
Scent Circle (your choice of scent)
Deluxe Sample of a Laundry product (your choice of product sample and scent)
Deluxe Sample of a Cleaning product (your choice of product sample and scent)
Deluxe Sample of a Body product (your choice of product sample and scent)
Coupon for 20% OFF (any order of $50 or more)
WAX CASH ($5 OFF any purchase of $50 or more)
Would you like to know how you can earn half-priced and FREE Scentsy products?
*
Yes
Maybe
No
On a scale of 1 - 10, how interested would you or a friend/family member be in hosting a Scentsy Scent Event or Sniff Session?
*
If you would HOST a Scentsy Scent Event or Sniff Session, what option would you be interested in?
*
In-Person Scent Event (at your home or other location of your choice)
Social Media Online Scent Event (i.e. Facebook Scent Event, etc.)
"Party on the Go" Bag/Catalog Party (you borrow my "Party on the Go" Bag to SHARE and SNIFF with friends, family, etc. and collect ANY orders to EARN REWARDS)
Text Scent Event - THE MOST POPULAR OPTION (I send you a Scent Event Link on the date of your choosing, and then you share the link with 10 or more friends, family members, etc. Your guests can shop at their convenience while you EARN REWARDS)
Do you have any friends or family members who would be interested in experiencing Scentsy products?
*
Yes
No
Please let me know what other Scentsy experiences you would be interested in (PLEASE CHOOSE ALL THAT APPLY)?
*
Warmer & Scent of the Month
Scentsy Club
Bring Back My Bar
Scentsy Fundraisers
Scentsy Gift Baskets
Scentsy Bridal Gifts
Scentsy Special Collections & Limited Time Offers (these include our Valentine's Day Collection, Easter Collection, Harvest Collection, Holiday Collection, Summer Collection, Mother's Day Collection and Father's Day Collection)
Scentsy Buddies/Buddy Clips
Scentsy "FREE SHIPPING FRIDAYS"
Customer Referral DISCOUNTS
Would you be interested in any of the featured Scentsy Licensed Collections?
*
Disney Collection
Harry Potter Collection
Star Wars Collection
NFL Collection
NHL Collection
Would you like to be on my MAILING LIST to receive Scentsy HAPPY MAIL (this includes items such as a Scentsy Catalog each season, NEW product information, monthly Newsletter, product samples, sales/promotions, updates, etc.)?
*
Yes
No
On a scale of 1 - 10, how interested would you be in joining my EXCLUSIVE Scentsy VIP Club ($50 for 12 months) where I SPOIL my customers?
*
Please type below any additional information that you would like me to know to help personalize your Scentsy experience:
*
Submit
Should be Empty: