DISTRIBUTION OPPORTUNITIES, hair loss shampoo,

REGENEPURE DIFFERENCE
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- RegenePure DR
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DISTRIBUTION OPPORTUNITIES

DISTRIBUTION OPPORTUNITIES

Become a Distributor of Regenepure Hairloss Shampoo

Salonceuticals is actively seeking distributors of our world-class scientifically formulated brand of shampoos. We offer bold wholesale pricing to physicians, salons, spas and retailers looking to meet the needs of consumers who want thick, clean, radiant hair and a healthy scalp — while netting a healthy profit.

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The RegenePure® family of products are an unparalled, nourishing addition to any hair and scalp-health regimen. Our complete line of products are Sulfate-Free, as well as, Paraben-Free — and are safe for use on color, Keratin, or chemically-treated hair. In addition, our products are packed with the finest ingredients and are never tested on animals.

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We are currently seeking select physicians and hair care specialists to join our distribution network. A variety of physicians, including dermatologists, transplant and hair specialists have successfully incorporated the RegenePure® family of shampoos in their treatment regimens and rely upon them for their nourishing as well as anti-inflammatory ingredients. The products are particularly effective in preparation for hair transplant surgery. And, the anti-inflammatory ingredients have noticeably decreased swelling in a post-operative setting. Hair feels fuller and the scalp healthier, even after only one use. More optimal results occur after repeated usage. RegenePure® NT and RegenePure® DR are scientifically formulated with the finest ingredients making them an excellent foundation for any hair and scalp health regimen. Apply now to become a RegenePure® Distributor in your area.

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Account Application

Date:

Physician's Name:
Practice Name:
Business/Billing Address:
City/State/Zip:
Business Phone: Business Fax:
Office Contact:

CONTACT INFORMATION (Please check all roles that apply per contact)

Contact 1: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

Contact 2: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

Contact 3: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

SHIPPING INFORMATION

Shipping Contact Name:
Email:
Practice Name:
Phone:
Fax:
Address:
City/State/Zip:

You will be responsible for all shipping charges. If you do not declare an account, we will use ours and add in the cost to your invoice.

Account Type: Small Packages Freight: Company Name (UPS/FedEx):

Account Number:
Associated Zip Code:

Shipping Instructions:

Order Information:

Ship Complete

Partial

No Back Orders

State Resale #: (Please attach a copy of your State Resale Certificate)
How long has your practice been in business?
Do you sell products online? Yes No

URLs to Storefronts:

Website #1:
Website #2:
Website #3:

CREDIT CARD AUTHORIZATION FORM

Visa Master Card Discover

Credit Card Number:
Exp. Date:
Name on Card:
Phone:

Billing Address:
City/State/Zip:

Date:

_______________________

I,, hereby authorize RegenePure | Salonceuticals to charge my credit card account when orders are shipped.

PLEASE FAX ALL PAGES OF THIS FORM & COPY OF RESALE CERTIFICATE TO THE ATTENTION OF THE ACCOUNT MANAGER AT 305.675.7621 REGENEPURE | SALONCEUTICALS 3148 W PEMBROKE RD HALLANDALE, FL 33009
Enter This Code >>

Salonceuticals is actively recruiting discriminating Aesthetic Centers, Salons and Spas to become a distributor of the RegenePure® line of shampoos. We offer sophisticated, world-class shampoos that are formulated with the highest quality ingredients and none of the components that damage or dull hair. RegenePure® NT RegenePure products are Sulfate- and Paraben-Free — thus making our brand one of the safest products on the market for hair that's been Keratin, color or chemically treated. RegenePure® DR provides intensive, topical skin care for the scalp, while leaving hair feeling soft, clean and thick — and helps eliminate dandruff and other aggravating hair conditions. Salonceuticals also offers a back-bar program to select salons and spas. To supplement your product lines with RegenePure®, apply now and our Salon Distribution Team will contact you immediately.

________________________________________________

Account Application

Date:

Business Name:
Business/Billing Address:
City/State/Zip:
Business Phone: Business Fax:
Office Contact:

CONTACT INFORMATION (Please check all roles that apply per contact)

Contact 1: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

Contact 2: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

Contact 3: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

SHIPPING INFORMATION

Shipping Contact Name:
Email:
Practice Name:
Phone:
Fax:
Address:
City/State/Zip:

You will be responsible for all shipping charges. If you do not declare an account, we will use ours and add in the cost to your invoice.

Account Type: Small Packages Freight: Company Name (UPS/FedEx):

Account Number:
Associated Zip Code:

Shipping Instructions:

Order Information:

Ship Complete

Partial

No Back Orders

State Resale #: (Please attach a copy of your State Resale Certificate)
How long has your practice been in business?
Do you sell products online? Yes No

URLs to Storefronts:

Website #1:
Website #2:
Website #3:

CREDIT CARD AUTHORIZATION FORM

Visa Master Card Discover

Credit Card Number:
Exp. Date:
Name on Card:
Phone:

Billing Address:
City/State/Zip:

Date:

_______________________

I,, hereby authorize RegenePure | Salonceuticals to charge my credit card account when orders are shipped.

High-End Boutiques and Retail Centers are invited to offer the most discriminating shampoo line ever formulated. Regenepure® Shampoos are formulated with superior ingredients and offer the finest hair cleansing experience. Our products are recommended and used by celebrities, high-end salons, physicians and successful professionals, making them appealing to your sophisticated clientele and profitable to you. Apply now to become a RegenePure® Distributor.

________________________________________________

Account Application

Date:

Business Name:
Business/Billing Address:
City/State/Zip:
Business Phone: Business Fax:
Office Contact:

CONTACT INFORMATION (Please check all roles that apply per contact)

Contact 1: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

Contact 2: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

Contact 3: Buyer Billing/Accounts Payable Mailings/Catalog

Name:
Email:
Phone:
Fax:
City/State/Zip:

SHIPPING INFORMATION

Shipping Contact Name:
Email:
Practice Name:
Phone:
Fax:
Address:
City/State/Zip:

You will be responsible for all shipping charges. If you do not declare an account, we will use ours and add in the cost to your invoice.

Account Type: Small Packages Freight: Company Name (UPS/FedEx):

Account Number:
Associated Zip Code:

Shipping Instructions:

Order Information:

Ship Complete

Partial

No Back Orders

Additional Shipping Locations

Shipping Contact Name:
Email:
Practice Name:
Phone:
Fax:
Address:
City/State/Zip:

You will be responsible for all shipping charges. If you do not declare an account, we will use ours and add in the cost to your invoice.

Account Type: Small Packages Freight: Company Name (UPS/FedEx):

Account Number:
Associated Zip Code:

Shipping Contact Name:
Email:
Practice Name:
Phone:
Fax:
Address:
City/State/Zip:

You will be responsible for all shipping charges. If you do not declare an account, we will use ours and add in the cost to your invoice.

Account Type: Small Packages Freight: Company Name (UPS/FedEx):

Account Number:
Associated Zip Code:

TRADE REFERENCES: (Please provide 3 references. If you don't have 3, please explain why.)

Reference Name:
Contact:
Phone:
Fax:
Address:
City/State/Zip:
Email:
Account Number:

Reference Name:
Contact:
Phone:
Fax:
Address:
City/State/Zip:
Email:
Account Number:

Reference Name:
Contact:
Phone:
Fax:
Address:
City/State/Zip:
Email:
Account Number:

State Resale #: (Please attach a copy of your State Resale Certificate)
How long has your company been in business?
Other product lines you sell:
Do you sell products online? Yes No

URLs to Storefronts:

Website #1:
Website #2:
Website #3:

CREDIT CARD AUTHORIZATION FORM

Visa Master Card Discover

Credit Card Number:
Exp. Date:
Name on Card:
Phone:

Billing Address:
City/State/Zip:

Date:

_______________________

I,, hereby authorize RegenePure | Salonceuticals to charge my credit card account when orders are shipped.

Distributors - Distributors interested in adding the Regenepure products to your inventory please contact us at distributors@regenepure.com

International distribution - If your organization is interested in distributing our products internationally please contact us at worldwide@regenepure.com.

Account Executives - We are currently hiring seasoned product representatives. We offer a generous compensation package including protected territories. Please email and include your resume to employment@regenepure.com

Website Owners - If you are a website owner and your users would be interested in our products please sign up for our affiliate program. Once your account is approved our system will provide you with a variety of banners and marketing material to use on your site. You will also be able to track impressions, clicks, and sales. Sign up today!

Refer a friend program- You use and realize the benefits of our products. Help your friends with their hair issues, refer your friends and family and get paid for it! Our advanced affiliate program will allow you to login and see your progress. You can even donate a portion of your income to charity. For more information please email us at friends@regenepure.com It’s easy to join, get started now!

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