First Name
*
Last Name
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Phone
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Email
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Who referred you?
Which beauty experience are you attending? Check all that you'd like to attend!
*
Teacher Appreciation Gift Package
Previous Consultant Beauty Package
Glow Up Kit (Skincare samples)
Glam Makeup Kit (Makeup samples)
Birthday Glow Kit!
In person Beauty Experience
In person Glam Sesh
Color Theory Sesh
Placing An Order
Street Address
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State
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What is your skin type?
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Normal to Dry
Combination to Oily
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What is your skin tone for foundation?
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Ivory
Ivory / Beige
Beige / Deep Beige
Bronze
Deep Bronze
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What is your eye color?
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Brown
Blue
Green
Hazel
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What are your skincare needs / concerns?
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More even or radiant looking skin
Improved skin texture
Skin firmness
Large-looking pores
Need extra hydration
Extra Oily
What is your age range?
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20s
30s
40s
50s
60s
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What are your eye are concerns?
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Deep wrinkles, puffiness & sagging
Fine lines and wrinkles
Tired and puffy looking eyes
Dark circles
Gentle makeup remover
Learning how to apply eye shadow for my eye shape
Other
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What are your lip area concerns?
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Fine lines and wrinkles
Dry lips
Lip color that matches me well
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Have you ever tried Mary Kay products before?
*
Yes
No
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