Walgreens– Coty


Please fill in the fields below to request your FREE sample^¥ of Coty Beauty, Inc. fragrances. Then click on "submit" to place your order.

	*required fields
* First Name
* Last Name
* Address 1
Apt, Suite, Unit, etc
* City
* State
* Zip
* E-mail Address
	All email addresses will be validated. Free Samples and other requested offerings will only be sent to those that provide valid email addresses.
* Birth Date	- -
* Gender	Male Female

The following questions are optional.

Do you buy the following?
	For yourself	As a gift	Buy for myself & as a gift	Do not buy
Fragrances
Cosmetics

Where do you typically purchase these types of products? (please check all that apply)
Brooks	Kohl's	Sephora
CVS	Kmart	Target
Duane Reade	Longs	ULTA
Eckerds	Meijer	Walgreens
Gottschalks	Rite Aid	Wal-Mart
JCPenney	Sears	Other/Grocery

Check here if you would like to receive promotional e-mails from Walgreens.com. By checking this box and providing your e-mail address, you will be contacted by Walgreens. See Walgreens.com Online Privacy and Security Policy for more information.

Check here if you would like to receive promotions, offers, and news from Beckham Fragrance.
Check here if you would like to receive promotions, offers, and news from JLo Fragrance.
Check here if you would like to receive promotions, offers, and news from Nautica Fragrance.
Check here if you would like to receive promotions, offers, and news from Shania by Stetson Fragrance.
Check here if you would like to receive promotions, offers, and news from Coty Beauty, Inc.

^¥While supplies last. Only the first 35,000 orders include Beckham Fragrance samples.

Please allow 4-6 weeks for delivery. Available to U.S. Residents only. Limit one sample per household. You must be 13 or older to receive this sample.