Ninety day satisfaction guarantee
Email a friend
Store

Please complete the form below and submit using the send info button. We will process your submission and reply to you within 48 hours.

Name:
Title:
Company:
Address:
City, State, Zip:
Phone:
Fax:
E-mail:
Company Information

Number of years in business:       Number of employees: Annual Sales:   Estimated Monthly Sales for Product of Interest:
Marketing Objective

Direct Importer     Wholesaler     Agent     Retailer     Direct Sales
Distributor     Government Agencies
Product of Interest

PER3 Deluxe Light Therapy Lamp    Clarity Skin Rejuvenation Light
Sun Touch Plus Light Therapy    Other (specify):
Please Check the Type of Distribution You will Use to Sell Our Products:

Department Stores    Catalog Mail Order    Telemarketing Using TV
Retail Stores    Dermatologists    Government Agencies
Beauty Salons    Health Spas    Senior Recreation Centers
Clinics    Pharmacies    Sleep Centers
Direct Marketing    Wholesale Distribution    Cosmetic Stores
Doctors    Hotels & Resorts    Other (specify):
Comments: