Application for Preferred Professionals Program

Name 

Address

City

State

Zip

Phone

Email

Website

Type of Birth Care Provided

Business Name

Average Number of Clients you work with Monthly

You will receive your inventory from Gnome And Lotus absolutely free of charge.  To qualify for this program, we require two personal references and a valid credit card number.  *You will not be billed anything to receive your inventory.

Personal Reference 1

Name:

Relationship

Address

City

State

Zip

Phone

Personal Reference 2

Name:

Relationship

Address

City

State

Zip

Phone

Credit Card Type   *Card will not be billed

Credit Card Number (leave spaces)

Expiration Date (xx/xxxx)

Name on Card

Billing Address if different than above:

Address

City

State

Zip

Any special directions or comments?

I have read and agree to the terms set forth below.  Please initial.

Initial
Date

Your information is kept completely private and secure.  

It will never be sold or used for any solicitation purposes. 

 

Terms:

We will require two personal references and a valid credit card number to open your account.  You will not be charged anything for your application or for your inventory.

You will receive an opening inventory based on how many clients you serve on average every month.

Requests to increase inventory will be gladly accommodated. 

Inventory shall be sold for established prices by Gnome And Lotus.

Payment for inventory sold shall be sent via mail to 6610 Folsom Auburn Rd Suite 5-8 Folsom CA  95630.  Acceptable forms of payment are personal check or money order.   Payment may also be made through PayPal to info@gnomeandlotus.com

Payment should be received by the 1^st of every month.

Unused product shall be returned at the expense of the client in saleable condition.

Should product be returned damaged and un-saleable, client authorizes Gnome And Lotus (Heather Harmon-Mayer) to debit the submitted credit card in the amount of product that is unusable.

Should payment not be received within 30 days of the date due (first of the month), and product has not been returned, client authorizes Gnome And Lotus, (Heather Harmon-Mayer) to debit the submitted credit card for the amount of product held plus a 10% transaction fee.

To quality for the 20% discount on personal orders, a minimum of $100 must be met.

Inventory will be replaced without charge.   

To re-order inventory mail a completed Inventory Request Form or send an email to Heather@GnomeAndLotus.com