Partner registration form

First Name *

Last Name *

Email Address *

Phone Number *

Which brand are you interested in? *

The name of your salon *

Where is your salon? *

Your salon's website

Profession/field of expertise *

How long have you been working in this field? *

Are you applying by yourself or with a salon? *

Which training are you interested in? *

Do you have any background knowledge in trichology *

Why would you like to attend our training?

In which country/town would you do the treatment?

Note: