Jessica Broughman Scentsy Order Form

Order Form

COMPLETE THIS ORDER FORM & I WILL PLACE YOUR ORDER TO MAKE SURE YOU GET THE BEST BUNDLE PRICES TO SAVE THE MOST MONEY & BE SURE TO CREDIT YOUR HOSTESS (IF APPLICABLE). Thank you SO MUCH for your order!
Your Full Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
If you are shopping with a party, who is the HOST of this party? ( I want to make sure they get credit!) :)

First NameLast Name
What would you like to order? Please be SPECIFIC with names of scents and names of warmers! (Don't worry about the bundle & save names- I will definitely bundle it the best we can-- to save you the most money!) :)*
Cell #, In case I have a question. :) I'll text you. :)*
Please enter a valid phone number.
Your email address*
example@example.com
Do you want to pick up your order from the my porch, your host or do you want me to ship it right to you? There will be a flat rate shipping charge if you have it shipped directly to your home*

Please ship to me for a flat rate of $10I'll do a porch pick-up (Jessica's house in Troutville, VA)I'll pick it up from the host
What is your mailing address? We need this to process your order plus I mail out a monthly VIP Smell Mail! I will mail a sample of the scent of the month to you!*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What is your Facebook Name so we can be friends? (many people use a different name on Facebook) :)*
How interested are you in sharing my scent testers with your friends & family to earn free & 1/2 price smell goods? It's soooo easy!*

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1 is Not at all Interested, 10 is Very Interested! Tell me everything!
If you have interest in booking a party to earn rewards, I do different types of parties! Which one would you like more info on?*

I'd like to do an online party where you mail my friends & family samples!I'd like to do a "basket party" where I carry around testers and catalogs and collect orders on my own.I'd like to do an in person party at my house or yours.I'd like info on a fundraiser. I have a team or organization that needs to raise money!Not InterestedOther
Have you ever thought of doing something like this to make a little extra money? There has never been a better time to give Scentsy a try! How interested are you in getting more info? No pressure, I'll just share what it entails & answer any questions that you may have! *

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1 is Not at all interested, 10 is I'd love to hear more about how it works!
How would you like to pay? (payment due at the time you place the order)*

Call or text Jessica with a debit/credit card (540-600-4540)Venmo (@jessicapbroughman)Cash App ($jessicapbroughman)PayPal - Friends/Family only (@jessicabroughman)
I do FUNDRAISERS! Large and small groups! Even individuals! I pay for the materials & provide prizes for group fundraisers! I also give 100% of my commission. Do you know of any organizations/individuals that could use a fundraiser?*

I do! Let's chat more about this!Let me think about it.I don't know any groups looking to earn money.Other
Questions and Comments here! We are SO SO THANKFUL for your support of our Family Business!
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