Scent Experience Request Form

Let's Get Scented!

Fill out this form completely to receive a special pack in the mail filled with Scentsy samples, and maybe even some SURPRISES! 🥳
FIRST Name
First Name Only
Last Name
Last Name Only
Facebook Name if different than above
Who is your party host?
The person who sent you the party info!
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have you ever tried Scentsy before?
If no, what do you currently use to fragrance your home?
Do you have a Scentsy Consultant Already?
Which fragrance families do you normally enjoy? - choose all that apply

Other
Tell me your most HATED scent and or Scentsy product?
When is your Birthday?
Month-Date
When is your Birthday?

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
What category are you MOST interested in?
What Other Interests Do You Have?
Did you know you can JOIN Scentsy and get paid back on all of your purchases?
I like to send out secret specials and other info via text on occasion. Would you like to sign up for my text alerts?
Thank you so much for filling this out! Anything else you would like for me to know? Or any questions you would like to ask? Feel free to text me if you have anything more! 419.362.8301
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