Wholesale

Full Name

Company Name

Tax ID # (if in Texas)

Are you online or offline business

Address

Type of License, Cosmetology or Business License?

Phone Number

Website

How did you hear about us?

Do you currently carry Nzuri products

Yes No

If yes where do you currently purchase Nzuri products?

Please list which NZURI Products do you currently sell?

Do you need Nzuri Marketing Materials?

Please list any Hair/Vitamins and Wellness products that you like to carry?

How soon do you need to order Nzuri products?

Immediately: Have someone call me ASAP Within the next 3 days Within the next 7 days Within the next 30 days

Nzuri's Return Policy

Dear NZURI Wholesale Customer,

Merchandise purchased and delivered from Nzuri Haircare and Wellness products and Solutions Hair Restoration and Wellness Clinic are final sale. Orders are not returnable unless approved by NZURI due to shipment error or defective merchandise. Please review your order carefully before submitting this application.

I have read and understood the Return Policy and Agreement and certify that the information submitted is true and correct.

Name Signature

Wholesale Website Address