Full Service Account Information Request
Margarete Polly - CosmoProf Inside Salon Sales Consultant
Corporate Name
Name of Corporation
Name
*
First Name
Last Name
E-mail
example@example.com
Phone Number
*
-
Area Code
Phone Number
Billing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Shipping Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Requesting Information Regarding (services, products, education, loyalty, etc)
Signature
*
Cosmetology or Business License (one required)
*
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of
Sales Tax Exemption License
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Sales tax will only be exempt for orders shipped to California. Orders shipped to other states will be taxed according to the applicable tax rate of the destination state.
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of
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