Order Form For Hair System (Repair)
(Print & mail with system)
Name ___________________________________
Date _________________
Address _________________________________
City __________________________ State__________ Zip Code________ Country________
Area Code and Phone Number (____)______________ E-Mail Address________________________
Contact Name _________________________
Short Description of System sent to Duplicate ________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Hair Type Desired: Synthetic:______________ % Human:______________ %
Style: Please indicate one:
Wave Or Curl Pattern:
(examples)
Body Wave___ Slight Wave___ Medium Wave___ Tight
Wave___ Medium Curl___ Tight Curl___ Finished
Hair Density: Light___ Medium___ Heavy___ Other___________________
Finished Hair Length:________ (Maximum finished
length is 7" with no extra charge)
Match color to System Yes___ No___
Scotch Tape Large Hair
Samples in appropriate boxes.(how
to take hair samples)
|
2
LEFT
TEMPLE
.
.
. |
4
BEHIND
LEFT EAR
.
.
. |
2
RIGHT
TEMPLE
.
.
. |
4
BEHIND
RIGHT EAR
.
.
. |
1
FRONT
.
.
.
. |
3, 5
TOP
.
.
.
. |
6
BACK
.
.
.
. |
Special Requests: _____________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Repair Cost is $150.00 + $10.00 shipping per
unit: Total $________
Please check one below:
[ ] Visa [ ] Mastercard [ ] Amex [ ] Discover [
] Check [ ] Money Order
(If CC order) Print Name___________________________________________
Account #: ___________________________________________
Expire Date: _____________________
Card Holder Signature __________________________________
Expect Delivery in aprox. 4-5 weeks.
No refunds
Cindycut Ordering Dept.
1155 W. Pioneer Blvd. Suite 103-133
Mesquite, NV 89027 USA
Custom Hairpiece Index
/
Hands on Hair
Replacement Training Free 30 day Trial on 98
minute DVD
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