Contact Person *

First Name

Last Name

Contact Phone *

Please provide the best number to reach you during M-F 9 am - 5 pm ET business hours.

(###)

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Stylist's Name *

Valid cosmetology license information must be provided for at least one on-site stylist.

First Name

Last Name

Salon / Address

Only accounts with complete Salon Information will be listed on Milbon's Salon Finder.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I would like to be listed on Salon Finder *

Yes

No

Shipping Address *

No P.O. Boxes. Please note that we cannot ship to the following states: MA, RI, CT, CA, NV, MI, OH, IL, IN, PA, NJ, VA, WV, and Washington D.C.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Liscio Certified? *

Yes

No

Diversion *

Milbon USA does not allow the online sales of any products, including on salon websites and platforms such as eBay or Amazon. By purchasing from Milbon USA you and all employees of the salon agree to Milbon USA's Anti-Diversion Policy.

I agree