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First- Print this form using your
browser Print function, then fill it out by hand
to mail to us!
Be sure to check out
"Included Features and Options"
If you need help filling out the
order form, click here or
on the numbers below!
Personal Information
Custom order hairpiece
Date:_________________
Name:___________________________________________
Mailing Address:_____________________________________________
City: _____________________ State: _______ Zip
Code: ________________ Country: ______
Reference (who this system is for):________________________________________
Telephone: ___________________________ E Mail
Address: _________________________
Hair Information
Order best hairpiece
[ ] This System will be for daily
or extended wear (usually but not always) for a
man.
[ ] Put a
replaceable lace
front on this System, or
[ ] Put a front
scallop on this System, or
[ ] Put a smooth
front hairline with underventing
[ ] This System will be an extended wear Integration
for a woman.
Synthetic:______________ % Human:______________
%
Custom order best hairpiece
[ ] Tape Template enclosed, or
[ ] Side to side:______________ inches. Front
to back:______________ inches.
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NOTE: If you want to use
an extended wear method of attachment, (bonding,
cable weaving) please measure 1/4 inch to
1/2 inch into your hairline on sides and
back so the system will be large enough
to attach to your hair. |
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If you can send us an
old system that fits, we will copy the size
and send it back with your new hair system. |
Order best euro hairpiece
[ ] Left part [ ] Center part [ ] Right part
[ ] Multi-directional
7. Color- Please
take large samples, see help page.
Attach hair samples here with tape.
Detailed Information on Color
[ ] Straight (no body) -human or synthetic
[ ] Slight Wave (light body wave) 30 mm -human
or synthetic
[ ] Standard (medium wave) 25 mm -human or synthetic
[ ] Tight Wave 20mm-human or synthetic
[ ] Loose Curl 15mm -human or synthetic
[ ] Tight Curl 10mm (human or synthetic)
[ ] Afro 2-6 mm -(synthetic only)
Custom order hairpiece
[ ] Extra Light (60%) [ ] Light (80%) [ ] Light
to Med. (90%)
[ ] Medium (100%) [ ] Medium to Heavy (120%)
[ ] Heavy (150%)
Order best euro hairpeice
Length of system- grey Percentage, etc. ________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
For Questions Call: 1-888-596-HAIR(4247) or
.
Ordering Information
Custom order euro hairpiece
1.___________How many Systems on this order?
2. $499.00____System Price
3.$__________Total of line 1 x line 2
4.$__________Longer length charges (see
#10 on Help page)
5.$__________Shipping ($15.00 per system- other
items may require additional postage)
6.$__________Sub-total-add lines 3 + 4 + 5
7.$___________
Tape tabs (5 pkgs./$20. ) How many total __________
(Frontal) A . Brown Liner [_] B.Red Tack
[_] C. White liner [_]
(Rolls) D. Brown Liner [_] E.Red Tack
[_] F. White Liner [_]
8._____________'Custom Hairpiece Lacestik' Lace
Tape (5 pkgs./$20.)-frontal tabs -How many?_____
______________________________List
additional items & prices here- Example:Bohyme
Remy Hair or Russian European Hair
______________________________If you need additional
space list on back of paper
$____________Total 6 + 7 + 8
$_-100.00_____Subtract if this is a system
reorder within one year
$____________Total amount due
Type of Payment enclosed: Full
payment is required at the time order is placed
unless other arrangements have been made.
Please check one below:
[ ] Visa [ ] Mastercard [ ] Amex [ ] Discover
[ ] Check [ ] Money Order
(If CC order) Print Name___________________________________________
Account #: ___________________________________________
Expire Date: _____________________ CVV #: ______________
Card Holder Signature __________________________________
Expect Delivery in aprox. 6-8
weeks. Thank you for your order
Remember to attach sample(s) of your hair , and
include Tape Template or old System, if any, along
with the order form and payment, and mail to:
No refunds on custom orders.
Custom Hairpiece Inc. Ordering Dept.
1155 W. Pioneer Blvd. Suite 103-133
Mesquite, NV 89027 USA
Custom order hairpiece
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