Hostess / Representative Form

Full Name:

Address:

City:

State:

Zip Code:

Email*:

Phone:

Alternative Phone:

Best way to communicate:

How did you hear about us?:

Have you ever been a rep for another company or hosted a home show:

No Yes

Children & Ages:

Interest & Hobbies:

City & Community Activities:

How long have you lived in the city/area:

Please list the cities/areas you plan to target:

Do you know any BBTN representatives or hostesses:

If there is not a need for a representative in your area are you interested in hosting a show in your home?:

No Yes

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