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Thank you for your interest in being a distributor for ORIKI Cosmetics.

Please fill out the following information and we will contact you as soon as your application is reviewed.

ORIKI Cosmeceuticals, Inc.
12698 Hoover St.
Garden Grove, CA 92841
USA

800-888-ORIKI
Tel 714-896-8050
Fax 714-896-8024

 
CONFIDENTIAL APPLICATION FOR INTERNATIONAL DISTRIBUTORSHIP

First Name    Last Name 
Business Name  
Title  
Owner         Manager Esthetician
Other Please Specify
Business Address  
 
City    Province 
Postal Code    Country   
Phone (Business)    Cellular 
Fax    Business website 
Email Address    Business License# 
Business Organization: Sole Proprietorship   Corporation   Partnership   Other
Years in Business         Number of Employees 
Experience in cosmetic distributorship  
Are you a distributor of other cosmetics       Yes       No
Describe your business'
major activities		  
Do you have the authority to enter a legally binding contract?       Yes       No
Additional comments  
Your application will receive priority if you provide us with additional information:
1)  Your business plan of developing your territory
 
2)  A list of relevant business contacts and trade references
 
Electronic signature (please type your name)  
Date  

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