Order Now: 1.877.225.0233

Wholesale Application Form

PFB Vanish REQUIRES ALL wholesale accounts to have a professional license to apply!
Please fill out one or both of the licenses, but wholesale businesses from CA only must also fill out the CA Resale (or type n/a).
No permits or non-active licenses.

Esthetician License #:
 
 
Cosmetology License #:
 
 
Business License #:
 
 
CA Resale Number *(CA only) enter n/a if not CA
 
 
Business Name *
 
Owner Full Name *
 
 
Your Position with Company *
 
 
Type of Business *
 
 
* I Plan to sell PFBVanish Products on Ebay  YES   NO  
* I Plan to sell PFBVanish Products on Amazon  YES   NO  
* I Plan to sell PFBVanish Products on My Web Site  YES   NO  

First Name *
 
Last Name *
 
Address *
 
City *
 
State *
 
Zip *
 
Phone *
 
Email *
 
Web Site Address *
  
 
Instagram
  
Facebook
  
* How did you hear about us? 
Ad? 
Which Ad?
 
Referral? 
Who?
 
Current User? 
Who?
 
Trade Show? 
Which Trade Show?
 
Other? 
What other?
 
Message *

Toll Free: 1.877.225.0233
T: 415.499.1985
F: 415.499.1987