Scentual Expressions Questionnaire

Scentual Expressions Questionnaire

Welcome to Scentual Expressions! Unveil the Essence of Elegance
Name*

First NameLast Name
Address*
City*
State*
Zip Code*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Which perfume creation service are you interested in? (Select all that apply)*

Perfume for yourself (check below)Perfume for someone (check below)Female fragranceFemale fragranceMale fragranceMale fragranceUnisex fragranceUnisex fragrance
Select the number of bottles you would like to create?*

(1) bottle of perfume(3) bottles of perfume(5) bottles of perfume
Favorite Color

RedBlueGreenWhiteYellowPinkPurpleOrangeBlackOther
How do you want people to perceive this scent?*

Glamourous & SexyAthletic & adventurousEdgy & ExperimentalMasculine
Favorite Style*

TrendyClassicMinimalSporty
Do you have a favorite fragrance? *

YesNoNot sure
If yes, enter your favorite fragrance here:
Do you want your fragrance to remind you of your favorite fragrance listed above?*

YesNo
When would you like to begin creating your personalized fragrance?*

I'm ready now3 months6 months
Is this for a special occasion or holiday?

BirthdayAnniversaryWeddingChristmasGraduationMother's DayFather's DayValentine's DayOther
CREATE YOUR PERSONALISED PERFUME IN 3 STEPS:
STEP #1 AMBREY & SPICY*

Amber RomanceDark MuskPink Orchid & Amber lMother's DayCrystal AmberAmber, Balsam, Leather, Musk
STEP #1 FRESH & CITRUSY*

Blast of BergamotBlood OrangeGingerYuzuSage and CitrusTangerine Dreams
STEP #1 FLORAL & DELICATE*

Fresh Cut RosesVictorian RoseTuberoseJasmineLily of the ValleyFrench LavenderButterfly FlowersFreesia FlowersOther
STEP #1 FRUITY & DELICIOUS*

Passion FruitFresh StrawberryZesty LemonGrapefruit - Ruby RedFresh PeachFresh Squeezed OrangeOther
STEP #1 WOODY*

SandalwoodTonka BeanOudVetiverSweet PatchouliPatchouli
STEP #2 SELECT FRAGRANCE BLEND*

THE MAN: Japanese grapefruit, bergamot, and lemon; followed by middle notes of peppercorn, ginger, jasmine, aquatic marine notes, and a hint of peppermint; sitting on expensive base notes of natural patchouli, cedar, vetiver, labdanum, and frankincense.PINK SUGAR: Fruity blend of cotton candy, lemon drops, caramel and raspberry jam on a dry down of musks.GRACEFULLY YOUR: Italian bergamot and sparkling lemon are sweetened with freshly picked citron and neroli. A white floral jasmine, orange blossom and rose are blended with sheer musk and cedarwood.SEXY FOR MEN: This scent contains top notes of pink lime, bergamot leaves, and tangerine. Middle notes of cinnamon bark, limewood, and sage. Vetiver and orange flower comprise the dry down.FRENCH SILK: soft and sensual bouquet of creamy French vanilla with sandalwood, patchouli, and musk accented by rose, violet, apricot, and creamy coconut milk.BOSS BABE: Delicate white and red roses, heady jasmine and spicy carnations blend with juicy melon and ripe plums, culminate to a sensual finish of precious woods and warming amber.
#3: CHOOSE YOUR DESIGN*
If you choose an image please upload it below.
#4: CHOOSE YOUR TEXT*
TYPE YOUR ENGRAVING
#5: CHOOSE YOUR FONT*

REGULARSCRIPTBOLD
#6: CHOOSE COLOR*

BlackSilverGold
#7: CHOOSE YOUR PERFUME CREATION PROCESS*

CREATIVE APPROACH: I'LL RECEIVE MY DIY PERFUME KIT: I would like to receive my DIY Kit, which allows me to fully engage in the process of making perfume at home. The package comprises a 24ml perfume base infused with alcohol, along with two recommended oil droppers. I will personally mix the oils to craft my own distinctive final fragrance.CONVENIENT CHOICE: SCENTUAL EXPRESSIONS PREPARES MY UNIQUE PERFUME CREATION: choose Scentual Expressions experts to blend my selected essences into the perfume base. I will receive a pre-made perfume, fully infused and ready for spraying and enjoyment. Kindly manage all the work on my behalf.
How did you hear about us?

ReferralDirect MailOnline AddSales CallPrint AdOther
Attachment

Please include any attachments (e.g., logo, images, etc.) that would help us better understand your personal needs.
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Your Note
Shipping Address for Product

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
My Product Selction
prevnext( X )
1 Bottle Customized Perfume
1 Bottles of Customized Perfume

$150.00 Quantity



3 Bottles Customized Perfume
3 Bottles of the Same Fragrance

$200.00 Quantity



5 Bottles Customized Perfume
5 Bottles of the Same Fragrance

$250.00 Quantity



Total

$0.00
How would you like to make payment:*

OUR SITE: Click link belowZELLE (816)591-5869PAYPAL: aroma@mallieboushaye.com - paypal.comIN PERSON:Other
- You will be navigated to our secure payment site.
- Click Link For Secure Payment Site
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