Product Sample Form
Name
*
First Name
Last Name
Phone Number
*
-
Country Code
-
Area Code
Phone Number
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Store Name/Enterprise
*
Store/Enterprise Name
Website
*
Website URL
Social Media Handles
Social Handles
Type of Business
*
Please Select
Cosmetics Wholesale
Cosmetics Retail
Herbal Shop
Pharmacy
Spa
Natural Products Distribution
Beauty Salon
Fitness Center
Supermarket
Other
Choose type of business
If other (Please specify)
Select Product Sample
*
African Black Soap (1Lb)
African Black Soap (5.2oz)
African Liquid Black Soap
Black Soap Paste
Baobab Oil (1Ltr)
Baobab Oil (8.45oz)
Neem Oil (1Ltr)
Neem Oil (8.45oz)
Baobab Powder (16oz)
Baobab Powder (8oz)
Moringa Powder (16oz)
Moringa Powder (8oz)
Cocoa Butter (32oz)
Cocoa Butter (16oz)
Cocoa Butter (8oz)
Ivory Shea Butter (32oz)
Ivory Shea Butter (16oz)
Ivory Shea Butter (8oz)
Kombo Butter (32oz)
Kombo Butter (16oz)
Kombo Butter (8oz)
Whipped Shea Butter (16oz)
Whipped Shea Butter (8oz)
Product Quantity
*
Please specify product quantity
Sample Descriptions
Please add any custom requests
Feedback
Please add any comments suggestions or feedback
Please note that due to production cost and shipping fees, you are required to pay a fee for samples. If you agree, please submit form. Thank you.
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