Pink Zebra Samples Request
Party Host, Event Name or how you found me
*
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Birthday
*
-
Month
-
Day
Year
Date
Preferred Contact Method
*
Email
Text
Both
Other
Paisley' Pick (Scent of the Month) Sample?
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Yes
No
Which 1 or 2 Sprinkles scents would you most like to try? Choose from the list below.
*
I would like to receive email updates with tips, special events, host/guest specials, and product sales?
*
Yes please!
No, thank you.
I'm interested in hosting a
*
Facebook party
Virtual Blend Bash
Text or Messenger party
VIP Scroll & Shop Party
Not at this time
Other
I'm interested in Hosting a Party in the month of:
January
February
March
April
May
June
July
August
September
October
November
December
I'm interested in receiving info on the following:
*
Scent Flirt - a surprise subscription monthly package
Opportunity Sneak Peek Pack to Join Pink Zebra
Application for HEROES FREE Daycare
Joining your VIP group
Other
Message
Submit
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