EarCandleLady.com
Distributor Registration Page
Professional Practitioner / Distributor Registration

Referring Distributor: EarCandles.net

Practitioner / Distributor Information

Social Sec. # (we will contact you directly for this information)

Name of Applicant

Mailing Address

City, State, Zip

Phone   

Email Address

Business Information  (If applicable--For Package Branding and 1099 Tax forms)

Company Name


The information I am providing is for EarCandles.net use only, and will not be
distributed to any third parties.  I understand that by submitting this application I will
become an independent distributor only, and am not an employee of EarCandles.net.  
I will purchase ear candles from EarCandles.net for personal and/or professional use,
and/or for resale.  I agree to hold EarCandles.net, EarCandleLady.com, 6K Adventures,
LLC and all other manufacturers, distributors and owners now and in the future,
harmless from liability in my performance as an independent contractor, practitioner, or
consumer of ear candles manufactured by EarCandles.net and it's affiliates.  By
submitting this application, I affirm that I am experienced and educated in the practices
of ear candling and take sole responsibility for my actions.




EarCandles.net
304 Market St
Gallatin, MO
(682) 559-8170
I agree to the terms and assume sole responsibility for my
actions as an ear candle practitioner and/or distributor.
Please Print this page for your records
Why do I have to fill
out this form?

We expect, that if you are
interested in bulk or wholesale
prices, you already ear candle
on a frequent basis and
therefore are knowledgeable
about the practice.

Our bulk and wholesale ear
candle packages do not
contain ear candling
instructions because, it is
assumed, you already know
how, and by submitting this
form you are documenting
that fact.

If you are unwilling to take
responsibility to follow or read
instructions, then you need to
purchase the specially
packaged retail products on
our
distributor's pages which
contain instructions and
specific waivers of liability.

We appreciate your
cooperation in keeping the ear
candle burning in the U.S.A.!
Please Note:You only
need to register once