VINE LUXURY EXTENSIONS are currently only available to Licensed Salons with appropriate Salon Licensing and Federal Tax Identification documentation. Please read this form in its entirety before applying to ensure that you meet all purchasing requirements.

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Name *

First

Last

Email *

Salon Name *

Salon Address *

Salon Address 2

(Suite Number, etc.)

City *

NUMBER Name Owner

State *

Zip *

Salon Phone Number *

Salon Owner Cell Number *

FEDERAL TAX ID NUMBER *

Please provide a current Federal Tax ID Number. Once application is received, you will receive an email requesting a formal copy of the document prior to final approval.

SALES TAX & USE NUMBER

Please provide a current Sales Tax & Use Number for State of Texas Applicants. Once application is received, you will receive an email requesting a formal copy of the document.

Email *

Submit