< back to Lexli Professional info page

You must be a licensed esthetician or dermatologist to apply. Please review our Wholesale Terms & Conditions to understand account requirements and details before applying.

Business Name*  
Buyer's Name*  
Email*  
Business Phone*  
Other Phone
Reseller Permit # (if applicable)
Business Address
Street  
City  
State/Province  
Zip Code  
Do you have multiple locations?
Company Web Address
List profile name/url of social media accounts
How many years has your business been in operation?  
Do you have a dedicated retail space?
 
Are you the primary decision maker for purchasing? (If no, please list the primary decision maker  
Describe your facility








 
How many licensed estheticians or skin care professionals are on your staff?  
Please list all services that you currently offer  
Would Lexli be the only skin care line offered in your business? If not, please list other brands you carry.  
What is your most important criteria in choosing a skin care line?  
How did you hear about Lexli?  
Enter your license information, or upload an image of your license.
Professional License Number
Licensing State/Province
Upload Your Professional License
Upload Completed Federal Form W-9*
Download Federal Form W-9, fill it out in your browser and save it to your computer. Upload it from your computer to this field before submitting your application.