Sign Up - KGL Skin Study Center

First Name
Last Name
Address
City
State
Zip Code
Birth Day
Phone
Email
Gender
Race
Eye Color
Hair Color
Contact Method
Location
Have you previously participated in a KGL study?
I have/had one or more of the following conditions:
Facial freckles, age spots, or uneven pigment
Crow’s feet lines
Undereye lines
Facial wrinkles
Acne
Rosacea
Psoriasis
Dry or sensitive skin
Eczema, atopic dermatitis, or allergies
My complexion is (chose one):
Fair – always burns, never tans (Caucasian)
Fair – burns easily, barely tans (Caucasian)
Medium - can burn, tans well (Caucasian)
Medium - seldom burns, tans very well (Mediterranean, Hispanic)
Dark - rarely burns, tans easily (Asian, Native American, African American)
Dark - rarely burns, deeply pigmented (African American)
Verification	7 × 1 = ?