TravelTan Systems

Registration Form

Main Contact Information:

Salon Name*

First Name*

Last Name*

Title*

Address 1*

Address 2

City*

State*

Zip*

Country

Phone*

Fax

Email*

Web Address/URL

Promotional Code

Questions About Your Salon:

Total # of Tanning Locations:

Total # of Tanning Units:

If this is a francise - Franchise Name:

When would you like to setup a Travel Display:

Now 30 Days > 30 Days

Package #1 - $199.00 Package #2 - $249.00

Name as appears on Credit Card*

Billing Address*

City*

State*

Zip*

Country

Payment Type:*

Credit Card #*

3/4 Digit Security Code (CVV) *

Expiration Date*

Month
Year

Yes

No

I Agree to the registration charge. I understand that this transaction is non-reversible. I authorize and acknowledge that all of the aforementioned charges will be processed to my credit card for the above mentioned persons/items.