Use this form if you are a cosmetology student or salon assistant to receive special discount rates. Proof of cosmetology school enrollment and/or employment must be provided via e-mail to receive special discount rates. Confidential special discount quotes will be emailed for purchase confirmation before processing.

Bill to:
First Name:
Last Name:
Address:
City:
State:
Zip/Code:
Phone:
Ship to:(if different from Billing address)
First Name:
Last Name:
Address:
City:
State:
Zip/Code:
Phone:
Name of Salon:
Name of School:
Yr of Enrollment:
*Email:
 
Submit the information below ONLY AFTER you have received purchase confirmation.
*Credit Card Type ex. Visa
*Credit Card # Exp.
Product Name:
Product Description:
Quantity Desired:
Additional comments or requests:

 

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Outside Tri-State Area: (877) SHEAR13 or (877) 743-2713
New York Sales Office: (212) 740-0723 -  e-mail: Shear Integrity
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