a:9:{s:6:"active";b:1;s:7:"subject";s:75:"[_site_title] "Complete Length Partnership Application and License to Sell"";s:6:"sender";s:43:"[_site_title] <info@psd.localserverweb.com>";s:9:"recipient";s:33:"Billiondollarindustry@outlook.com";s:4:"body";s:1646:"First Name: [first-name]
Middle Name: [middle-name]
Last Name: [last-name]
Licence Number: [licence-number]
Home Address: [home-address]
City: [city]
State: [state]
zipcode: [zipcode]
Home Phone: [home-phone]
Work Phone: [work-phone]
Cell phone: [cell-phone]
date-of-birth: [date-of-birth]
Email Address: [email-address]
Social Security No :[social-security-no]
Describe Race: [describe-race]
Describe Ethnicity: [describe-ethnicity]
Male Female: [male-female]
Complete Length Hair: [complete-length-hair]
Credit/Debit card:[credit-debit]
Expiration date:[expiration-date]
Security Code:[security-code]
Termination Year: [termination-year]
Married Single Divorced: [married-single-divorced]
Complete Length Consultant: [complete-length-consultant]
Relative 1: [relative-1]
Relative 2: [relative-2]
Facebook: [facebook]
Recruiter Name: [recruiter-name]
INDEPENDENT SALES DIRECTOR’S SIGNATURE:[independent-sales-director-signature]
Your Signature:[your-signature]
Date Signature: [date-98]
Initial Here: [initial-here]
Mxed Case: [mixed-case]
Gallon Case: [gallon-case]
Language: [literature]
Shipping Charge: [shipping-charge]
Subtotal: [subtotal]
Sales-Tax: [sales-tax]
Total Cost: [total-cost]
Distribution Instructions: [distribution-instructions]
Name-a: [name-a]
Address: [address-a]
City State Zip: [city-state-zip]
Checking  or Savings :[radio-812]
Bank Account: [account-number]
Bank Routing: [text-451]
Date:[date-65]
Financial Institution:[FinancialInstitution]
Checking or Savings:[radio-812]
signature: <img src="[signature]" alt="" width="150" height="100" />

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