PLEASE NOTE: Ready-to-ship Lipkits are limited.

Distributor ID # *

First Name *

Last Name *

Email *

Qualifications:

1. You must be an active SeneGence Distributor in good standing.

2. All charities/organizations will be vetted before sending product.

3. ALL items are NOT FOR RESALE - reselling any of these will be grounds for termination.

4. Donated kits MUST contain the MSF LipSense Instruction Card. (You are welcome to include your own card)

Please indicate below your shipment preference: Individual products sent to kit yourself or Ready-to-ship LipKits *

Individual product to kit

Ready-to-ship LipKits (includes all 6 colors, 1 diamond gloss, 1 oops, and instruction card)

Indicate number of boxes you need. Each box contains 50 completed lipkits.

LipKits

(0 remaining)

5x7 White Organza Bags

Indicate how many you need - or put in 0 if none are needed

MSF LipSense Instruction Cards
Indicate how many total instruction cards you need.
YOu can put in a 0 if you do not require any. *

Please order by number of boxes.

Each box of LipSense contains 200 pieces. If you need to build 400 kits,
you will put in 2 next to the product items you want.

We cannot break a box - example, we will not send less than 200 of each color/item. Each box contains 200 items and that is the minimum to request.

For any items you DO NOT WANT - please put in a 0 - EACH box must contain a number to submit.

Bombshell *

Nude *

First Love *

Mauve Ice *

Honey Rose *

Apple Cider *

Diamond Gloss *

Ooops Remover *

Please provide SHIPPING ADDRESS below:

Note - this cannot be the same as the Organization Address.

Shipping Address *

City *

State *

Postal *

Delivery Date
*Please note we will do our best to deliver by date requested,
however there may be some delays depending on time for preparation. * +

Orders in excess of 600 may require distributor pick up or shipping fees.

Per IRS requirements, we need the name of the organization receiving the kits and their address.

We cannot send kits without this information and it cannot be the same as the shipping address - UNLESS - you are shipping direct to organization.

Organization Name: *

Organization Website/Facebook page: *

Tell us more about who will receive the kits. (Include why, how many people will be served, and list any events associated with your donation of LipSense) *

Address *

Suite Number (if applicable)

City *

State *

Postal Code *