(Print & mail with hair system for repair)
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 /Curl Pattern:
Body Wave___ Slight Wave___ Medium Wave___
Tight Wave___ Medium Curl___ Tight Curl___ Finished
Hair Density: Light___ Medium___ Heavy___ Other___________________
Finished Hair Length:________ (Max. 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)
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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 $165.00 + $15.00 shipping per
unit: Longer lengths, Remy or Russian
hair or replace lace front is additional cost
-Total $________
Please check one below:
[ ] Visa [ ] Mastercard [ ] Amex [ ] Discover [
] Check [ ] Money Order
(If CC order) Print Name___________________________________________
Account #: ___________________________________________
Expire Date: _____________________ CVV#: ______________
Card Holder Signature __________________________________
Prepayment is expected with order.
Delivery in aprox. 4-5 weeks. No refunds
Cindycut Inc. Ordering Dept.
1155 W. Pioneer Blvd. Ste. 103-133
Mesquite, NV 89027 USA
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