Company Name*
    Owner/Applicant Name*
    Business Address
    Business Address2
    City
    State / Province / Region
    Zip
    Country
    Business Phone*
    Business Email*
    Website*
    Business Status*
    Applicant Address*
    Applicant Address2*
    City*
    State / Province / Region*
    Zip*
    Country*
    Home Phone*
    Partner/Manager's Name*
    Number of Years at Location*
    Number of Years in Hair Replacement*
    Do You Have More Than One Location?*
    (If you have more than one location, please list complete address of each location in the text box below.)
    Location Addresses

    (If you have more than one location, please list complete address of each location.)
    How Many Employees Do You Have?*
    Type(s) of Non-Surgical Attachments Offered?*
    Do you offer Women's Hair Systems?*
    What is your price range (high/low) for an individual men's system?*
    What is your price range (high/low) for an individual women's system?*
    What is your price range (high/low) for a men's program sale/multiple systems?*
    What is the approximate yearly dollar volume of your non-surgical hair business?*
    Do you offer products to stimulate hair growth?*
    What are your current Advertising Mediums?*
    How much do you currently spend on advertising, yearly, on non-surgical hair?*
    Do you offer Replacement Surgery?*
    Is surgery performed at the above premises?*
    What is the approximate yearly dollar volume of your surgical business?*
    How do you charge/price out your surgery?*
    How much do you currently spend on advertising, yearly, on surgical hair?*
    Are you a member of the BBB?*
    What other organizations do you belong to?*
    Will you be able to attend the annual, two and a half day Transitions meeting, wherever it may be held as determined by a majority vote of the members?*
    Are you willing to share reasonable additional expenses with other Transition members to produce photo/video materials, tv commercials, and other advertising materials and certain developmental expenses that may be incurred by the group, as determined by a majority vote?*
    Do you understand this group is not a platform for selling your product or services, but it is about sharing and creating marketing ideas and materials?*
    Are you a wholesale distributor of hair-related products or do you offer other services to the hair-related industry?* (If so, please tell us what and to whom you distribute or supply and describe your territory in the text box below.)
    Wholesale/Services
    Are you affiliated with another hair replacement group or association?* (If so, please describe the relationship in the text box below.)
    Other Affiliations
    Do you develop your own marketing materials?*
    Have you purchased or leased Marketing Materials from wholesalers?* (If so, please describe what type of materials you needed.)
    Materials Purchased or Leased
    Accepted file types: jpg, png, gif, pdf
    Accepted file types: pdf, doc, docx, jpg, png
    Bio of Owner
    0 (1500 max characters)
    By clicking yes, and hitting the submit button below, you understand the exclusive Membership Territory as determined by the Transitions Designated Market Area Map, as shown on the Web site unless otherwise specified by the Transitions Administrator.*
    By clicking yes, and hitting the submit button below, you also understand that all of the information on these Applications and Agreements will be held in the strictest of confidence and will not be discussed with anyone other than Transitions Members.*