LeilasBeautyBoxSubscription

Hello Gorgeous!

Subscribe Today to Leila's Beauty Box - starting at $50 a month! Receive a semi-customized gorgeous box of products, samples, and exclusive offers of Mary Kay products redeemable with ME, your favorite Mary Kay Lady! Royal Subscribers (or quarterly subscribers) receive a free gift after every 3rd Beauty Box! Email questions or comments to LeilasBeautyBox@gmail.com
Name*
When's Your Birthday?

MonthDayYear
Date
E-mail*
Please add me to your emailing/Text/mailing list?

YesNo
Phone Number*
Best Way to Contact You*
Shipping Address*
Is a Mary Kay Person servicing you at this time?*

NoYesOther
What's Your Age Range?

18+60s20s70s30s80s40s90s+50sUnder 18 must have parents permission
SKIN TYPE

Describe your skin type, needs, and concerns. Check all that apply.
What Is Your Skin Type?

NormalDryOilyCombination
What Are Your Skin Care Needs?

sensitive skinmild to moderate acnebasic routine no aging concernsearly to moderate signs of agingadvanced signs of agingnatural
Other Skin Care Needs or Concerns? SPF Sensitives?
I Want More......

even or radiant looking skinimproved skin textureskin firmness and resilienceextra hydrationMaximum HydrationOther
I Want Less......

excess Oillarge looking poresdeep wrinkles & expression linesacne signsOther
Eye Area Concerns (Check all that apply)

Fine lines & WrinklesTired & puffy lookingDeep wrinkles & linesGentle makeup removerPuffiness and or saggingOther
Lip Area concerns (Check all that apply)

Fine lines and wrinklesDry Lips
Foundation & Colors

Foundations & Makeup colors you like the best! Match your foundation shade with your undertone:
Cool Undertones - Easily burns / turns red/pink / or stays the same in the Sun
Warm Undertones - Tans or deepens in the Sun
Neutral Undertones - Sometimes burns or skin tone deepens after Sun
Preferred Foundation Finish

MatteNaturalLuminous/Dewy

Foundation Shade & Undertones

Rows	Light Ivory	Ivory	Light Beige	Beige	Light Bronze	Bronze
Cool Under Tones
Warm Undertones
Neutral Undertones
Not Sure

Beautiful Colors (Check all that apply)

Rows	Warm Colors	Cool Colors	Neutral Colors	Mattes	Shine/Gloss	Metals	Smoky	Fun	All Colors	No Colors
Eye Color
Cheek Color
Lip Color

Eye Wear (Mascaras)

I prefer BlackNo color preferenceI prefer BrownI don't wear mascara
Eye Wear (Eyeliner)

I prefer BlackNo color preferenceI prefer BrownI don't wear eyelinerI like to try colors if available
Eye Brows

BlondeDark BrunetteDark BlondeBrunetteI don't wear brow makeupOther
Were You Referred To Leila's Beauty Box by Anyone? Please List Their Name Below So I Can Give them $5 off their next box!
Please Pick Your Subscription Package! Tax & Shipping does apply.*

Leila's Beauty Box Monthly Subscription choices: Pink $50, Silver $75, or Gold $100.

Monthly Gift Subscription: Leila's Beauty Box (Includes Free Gift Messages) Can ship to gift recipient.$50.00

QuantityMonthly Subscription Box Options

Monthly Subcription: to Leila's Beauty Box (For Yourself)$50.00

QuantityMonthly Subscription Box Options

Monthly Subscription: Free Local Delivery (High Desert-Victorville, CA Area Only) *ENTER COUPON CODE: LOCALHD to get Free Local Delivery. (*If shipping address is not in the High Desert area, $5.00 will be added for shipping)$50.00

QuantityMonthly Subscription Box Options

Special Deluxe! Pre-Pay Your Quatertly Subscription & get FREE SHIPPING on ALL 3 Beauty Boxes! $150.00

QuantityQuartly Pre-Pay Box Options

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Subtotal $0.00Tax $0.00Shipping $0.00Total $0.00

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