Thank you for your interest in being an UltraRay stockist!

Interested in becoming an UltraRay stockist? Please complete this form; our team will review and approve your account within 3-7 business days and follow up with further information and instructions.

Please email ultraray.luxuryspa@gmail.com if you have any additional questions.

Contact/ Buyer's Name

First Name

Last Name

Email

Title

Shop Name

Instagram Handle

Shop Website

http://

Shop Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shipping Address (if different from the shop address)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Resale ID

Type of Store

Brick + Mortar Retailer

Online Retailer

Rep/ Distributor

Message

Thank you for your interest in being an UltraRay stockist!

UltraRay, A Luxury Spa LLC

Temporary Extended Hours

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