EmailMe Form - Airbrush Spray Tanning Form

Today's Date

MM / DD / YYYY

Name *

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email *

May we email you promos and other discounts? *

Yes

No

Solution Brand Preferred: (If Known)

1. Would you like your face tanned? *

Yes

No

2. Would you like to use any of the following: (Check all that apply) *

3. How do you tan in natural sun light? (Please select One) *

Always Burns--Never Tans--1

Burns Easily--Gets a Light Tan--2

Tans Easily--But Can Also Burn--3

Tans Easily--Rarely Burns--4

Tans Easily--To a Dark Rich Brown, Rarely Burns--5

Tans Very Easily--Never Burns--6

Please only select 1 option.

4. What is the occasion for the tan? *

5. Between 1 and 10, how dark would you like to be?

Disclaimer:

If you have skin type 1 or 2, there is not enough melanin in your skin to get really dark. If you request a solution for a darker skin type, you will possibly turn orange.

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