JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Beautycounter Free Samples Request
GET THE SAMPLES YOU NEED: Fill out the form below so I send the best samples for you. :)
***Please be patient. I sometimes get a bunch of requests all at once, but I'll get them to you as quickly as I can!
•Check out Beautycounter products here:
https://KellytheKitchenKop.com/BC
Links you might like to check out:
•Please join my private Beautycounter group on Instagram (
https://Instagram.com/Kitchen_Kop_Beautycounter
) and/or Facebook (
https://www.facebook.com/groups/kitchen.kop.beautycounter
), where I'll have occasional parties or other random product giveaways!
•Read more here in my Beautycounter Review:
https://KellytheKitchenKop.com/2019-Beautycounter-Review/
•Here's an update with my fun news:
https://kellythekitchenkop.com/2020-wasnt-all-bad-heres-some-crazy-fun-news/
•Watch my Beautycounter intro videos:
https://www.youtube.com/playlist?list=PL6JRV3Cfi22SJgW2BKZBs0BhmzUtYXEn3
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Full name
*
Your answer
Email address (this also gives me permission to email you about Beautycounter sales, etc. if you're not already getting my newsletter)
*
Your answer
FULL address where I can send the samples
*
Your answer
Cell Phone Number
Your answer
How do you prefer I reach out to you?
*
Phone call
Text
Email
Anything is fine!
What are your skincare needs/concerns so I can send you the best samples available? (Choose as many as apply)
*
Safer makeup that works
Uneven skin tone/blotchy/redness
Dry skin
Eczema
Oily skin
Acne or blemish-prone skin
Scars from acne or other
Combination skin
Normal skin
Age/wrinkle prevention
Age-reversal/wrinkles
Brown spots/age spots
Sensitive/reactive skin
Safer haircare products
Safer baby/kids products
Safer products for men
Safer sunscreen
Gifts for family, teachers, etc.
Required
Please tell me about your current skincare and makeup routine?
*
Your answer
Any other skincare or makeup concerns or questions not mentioned above? (Also share here if there are any samples you were specifically hoping to try out.)
Your answer
Are you a new or existing Beautycounter customer? (Click 'existing' if you've ordered before.)
*
New
Existing
How did you find me?
*
Your answer
If you like free shipping & saving money, consider a Band of Beauty membership: for $29 you get... 1. a free gift for joining worth $43 when you spend $50, 2. 10% product credits with each purchase, 3 free shipping on orders over $100 (no auto-ship or purchase requirements!), 4. Special periodic offers. Are you already a Band of Beauty member?
*
Yes
No
Send more info
Can I also add you to my Kitchen Kop newsletter? (1 email/week usually, plus get a free Grocery Store Cheat Sheet, help with natural remedies, real food recipes, etc.)
*
Yes
No
I already get Kitchen Kop emails at the email address above
Would you like to earn from home and have flexible hours? Have you ever thought about the business side of Beautycounter?
*
Yes
No (not right now anyway!)
Maybe
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kelly the Kitchen Kop.
Report Abuse
Forms