JA Direct Registration Form

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JA Direct Client Registration Form

John Abaté Direct is a wholesale only site; YOU MUST HAVE A VERIFIABLE RETAIL TANNING BUSINESS TO BE A REGISTERED USER TO THIS WEB SITE. To apply for online access, simply complete the form below. Your application will be reviewed and verified by a JA staff member usually within 48 hours Monday through Friday.

Once approved, the username(please use email address) and password you provided us will be activated. You will receive email notification of your activation.
*If you are a tanning consumer, please visit your nearest professional indoor tanning facility for quality JA products or call 1-800-532-9035.

Full Name:
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Business Name:
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Email Address:
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Address:
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City:
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State:
*
Zip Code:
*
Please select a username and password that you will remember. The Username and Password can not contain any spaces. All spaces will be removed from them. They must be from 3 to 12 characters long. Only use letters and numbers.
Preferred User Name(email address):
*
Preferred Password:
*
If you have a promotion code please enter it here:
Phone number must be used as a business number:
Business Phone Number:
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How long have you been in business?
*
What type of business license do you hold (Business-Sales Tax-Tanning ...)?
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License Number (if applicable):
Services Offered-In Addition To Tanning

Tanning (Primary)
Sunless Booth
Sunless Airbrush
Hair
Spa Services
Fitness
Other
If you have spoken to a JA sales representative please enter the JA Sales Rep's name.
JA Sales Rep Name:
Security code:
*
Do not enter anything in this field:

* indicates a required field

NOTE: This site is intended for use by approved, qualified indoor tanning salon owners. Unauthorized use of this site is strictly prohibited. Please use our contact page to report any misuse of this site.