	Lucky Hair Shears • Specializing in Hair Scissors and Shears Call 1-888-739-0439

Lucky Hare Dealer Application

Complete the application below. Upon application approval you can register in our online store and you will be given Dealer status, entitling you to our Dealer discounts.

All fields are required unless otherwise noted (optional).

First Name

Last Name

Title

Organization

(e.g. Company Name)

Phone Number

Cell Number

(optional)

Email

Website

(optional)

Address

Address (cont)

(optional)

City

State

Zip Code

3 Trade References of Companies you do business with.
At least 1 is required.

Reference 1

(required)

Phone #

(required)

Reference 2

(optional)

Phone #

(optional)

Reference 3

(optional)

Phone #

(optional)

Additional information (optional)