Charles Worthington Beauty Panel Application Form

Would you like to join our exclusive Charles Worthington Beauty Panel?

Fill out the form below to apply to be a part of our panel. If you become a member, you will receive complimentary Charles Worthington products to try at home & review online. For every review you leave, the products get bigger and better as a way to reward our most loyal reviewers.

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First Name

Last Name

Date of Birth

Email Address

Address Line 1

Address Line 2

Town/City

County

Postcode

What look do you want to achieve with your hair? (Tick all that apply)

Moisturised and softened Strong and healthy Big and bouncy Protected from colour fade Frizz-free and smooth Perfect curls High shine

What hair products interest you? (Tick all that apply)

Shampoo Conditioner Intensive Treatments Styling Products

Do you colour your hair?

What is your hair colour?

What is your Boots.com screenname/nickname? See below for help finding yours

I would like to apply to be a part of the Charles Worthington Beauty Panel and opt-in for the Charles Worthington email newsletter

Not sure what your Boots.com nickname is?
You will find your nickname when you sign in (or register) on Boots.com and click to submit a new review on a product page, then scroll down to "My Information" and your nickname is listed.