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Independant Consultant Application
Terms and Conditions

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Huckleberry Layne Candles & Gifts, LLC

 Independent Consultant Application

Contact Information

Full Name:
*
Desired Password: ( for website )
*
Social Security Number:

Home Phone:
*
Date of Birth: ( M/D/4 Digit Year )

Email Address:
*
My main reason for signing up is: ( check all that apply )
I love the Products
Start my own Business
Meet/Make new friends
Need a night out
Income Potential

Billing Information
( APO's cannot be used )

Billing Address:
*
Billing City:
*
Billing County:
*
Billing State:
*
Billing Zipcode:
*
Within City Limits?
Yes
No

Mailing Information:   Same as Billing Address
If Mailing Address is different please fill in below.

Mailing Address:

 

Questions or Comments:

 

By my submittance below, I certify that the above information is correct and that:
I am at least 18 years of age and have legal capacity to enter into this Independent Consultant Agreement.
I have read, understand and agree to be bound by the terms and conditions of this Independent Consultant Agreement.
The SSN/ITIN/EIN, shown above on this form is my correct taxpayer identification number and without a correct SSN/ITIN/EIN, I will be subject to statutory withholding on all royalties and prizes.
I authorize Huckleberry Layne to obtain a credit bureau report, to report my credit activity to credit bureaus, and to charge a late payment fee up to the maximum legal amount per month on any unpaid delinquent balances.  I understand and agree that any credit being extended to me by Huckleberry Layne is solely for business purposes and not for personal, family, or household purposes.
If this Independent Consultant Agreement is accepted by Huckleberry Layne, I will abide by all policies and procedures as stated and announced from time to time by Huckleberry Layne.
I understand that in order to activate my Huckleberry Layne account, I am required to purchase a Start Up Kit and supplies needed to begin my Huckleberry Layne business.
All Agreements are subject to acceptance by Huckleberry Layne Candles & Gifts, LLC, whose acceptance will be evidenced by opening an account in the name of the Independent Consultant.


I agree to pay the one time sign up fee of $75 plus shipping & handling.  Please choose from available Starter Kit Packages found in Starter Kit Link in the Categories Section.
I have read and agree to Terms of Service
Yes
No

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Featured Items

Sports Bear w/ School Colors
Sports Bear w/ School Colors
$17.50

28oz Apothecary Jar
28oz Apothecary Jar
$19.95

Reed Diffuser Kit
Reed Diffuser Kit
$18.95

Dead Sea Bath Salts
Dead Sea Bath Salts
$6.95

 


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