2024 VENDOR PLATINUM PARTNER

2024 VENDOR PLATINUM PARTNER

ANNUAL MEMBERSHIP ACTIVATION FORM

- Step 1 of 4

PLEASE SELECT MEMBERSHIP LEVEL *

2024 VENDOR Platinum Partner - $600.00

(Membership Level Exclusively for Vendors)

ARE YOU A NEW PARTNER OR RENEWING PARTNER MEMBER? *

New
Renewing

Save and Resume Later

Business Information

Please complete the information below exactly as it should appear on the ROMOSA web site.

OTHER THAN THE COMPANY NAME, HAS ANY OF THE FOLLOWING BUSINESS INFORMATION FOR THIS MEMBERSHIP CHANGED? *

Yes
No

Layout

Company Name *

Company Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Website / URL *

Company website or if none, your primary social media channel (i.e. Facebook, Instagram, or LinkedIn)

File Upload

Click or drag files to this area to upload. You can upload up to 5 files.

Please upload a transparent .PNG of your logo and/or approved media content for use on our website if applicable

Select If Billing/Shipping Address Is Different Than Above

Billing/Shipping Address

Address Line 1

City

State / Province / Region

Postal Code

Country

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Primary Contact

Note: Your personal information will only be available on the secured “members only” location on the web site. You are not required to fill out any information you do not wish to share with other members. Only your Spa Name, address and web address will appear on the “public” areas of the web site.

HAS THE PRIMARY CONTACT INFORMATION FOR THIS MEMBERSHIP CHANGED? *

Yes
No

Name *

First

Last

Role/Position/Title *

Layout

Email *

Phone *

Secondary Contact

(applicable to Spa Gold & Vendor Platinum Member Partners only)

HAS THE SECONDARY CONTACT INFORMATION FOR THIS MEMBERSHIP CHANGED? *

Yes
No

Name *

First

Last

Role/Position/Title *

Layout

Email *

Phone *

Save and Resume Later

Purchase & Activate Your Partner Membership

Complete your credit or debit card payment when prompted to receive Instant Access to all of your Partner Membership Benefits!

Payment Method *

Credit/Debit Card (Instant Access)
Check or ACH Transfer (Delayed Access)

*Instant Access requires completed credit or debit card payment when re-directed after submitting this form. Check or ACH Transfer payment option receives access to all Partner Membership Benefits once invoice is paid-in-full. Invoice will be sent via email within 1-3 business days of submitting this form.

Save Me Time & Auto-Renew My Membership Annually! *

Yes! Save me time and subscribe to auto-renew my Partner Membership Annually.
No. Send me a reminder each year to renew my Partner Membership.

Total Amount Due:

$0.00

Promo Code

Received a promo code? Enter it here. (Promo codes not eligible for auto-renewal membership option.)

Payment Information *

Card Number

Expiration Date

Security Code

Card Holder Name

Signature *

(Authorization for your purchase and membership activation)

Message

Save and Resume Later

Heads up! Saving your progress now will store a copy of your entry on this server and the site owner may have access to it. For security reasons, sensitive information such as credit cards and mailing addresses, along with file uploads will have to be re-entered when you resume.

Your form entry has been saved and a unique link has been created which you can access to resume this form.

Enter your email address to receive the link via email. Alternately, you can copy and save the link below.

Please note, this link should not be shared and will expire in 30 days, afterwards your form entry will be deleted.

Copy Link

Email *

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