If you are a retailer/distributor and can invest $250 USD 
on an initial order and would like to become a vendor 
of Medusa's Make-Up, please fill out the form below. 
 We will respond within 24 hours, Mon-Fri.

 

 

 

 

 

 
*Required
*Business Name
*Buyers Name
*Street Address
*City
*State/Province
*Postal Zip Code
*Country
*Telephone
Fax
*Email
*Confirm Email
*FEIN
Tax ID number
*Website
*Where do you plan on selling Medusa's Make-Up (store front, online store, kiosk, other explain)
*List products that you currently sell
*How did you hear about us
Additional Comments

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