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Sample Request Form
Interested in Beautycounter but want to try some products first? Use this form to let me know what samples you’d like to try or reach out and I can customize some for you based on your skin type/ concerns!
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Email
*
Your email
Full Name:
*
Your answer
Full Mailing Address:
*
Your answer
Instagram Handle:
Your answer
Select 2-3 samples you would like to try:
*
All Bright C Serum
Overnight Resurfacing Peel
Charcoal Face Mask
Lotus Glow Cleansing Balm
Countertime Sampler Pack (Anti-Aging line)
Countermatch Sampler Pack (Optimal Hydration line)
Countercontrol Sampler Pack (Oily & Acne Prone line)
Counterman Sampler Pack (Men's line)
Skin Twin Foundation
Skin Twin Concealer
Mineral Sunscreen Lotion SPF 30
Other:
Required
Are you a current customer of mine?
*
Yes
No
Have you used Beautycounter products before?
*
Yes
No
If someone referred you to me, please list their name here:
Your answer
Are you interested in becoming a consultant?
*
Yes, I want to learn more!
No, not right now
Maybe, gotta think about it.
Send me a copy of my responses.
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