Hair By Mail
New System Order Form
50% deposit needed, No Exceptions
Mail your order to:
1366 NE 163rd Street Suite #200
North Miami Beach, Florida 33162
Name___________________________________
Date_________________
Address_________________________________
City__________________________ State__________ Zip Code________ Country____________
Area Code and Phone Number (____)______________ E-Mail Address___________________________
Wearers Name or Initials_____________
Short Description of System sent to Duplicate ___________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Hair Type Desired: Human Hair___ Synthetic Fiber___
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 5" 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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LEFT TEMPLE . . . |
BEHIND LEFT EAR . . . |
RIGHT TEMPLE . . . |
BEHIND RIGHT EAR . . . |
FRONT . . . . |
TOP . . . . |
BACK . . . . |
Special Requests: ________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
Quantity Ordered _____ Additional charge for longer finished lengths.
Charges double for Oversize Systems and Full Wigs. There will be an additional charge added
for extra heavy density and Oversize Systems and Full Wigs
Price of First System Ordered
249.99 Add 30.00 Ea. for 6" to 7" Finished Length
Second System199.99 ____ Add $40.00 Ea. for 8" to 10" Finished Length
Additional Charges ____ Add $50.00 Ea. for 11" to 12" Finished Length
Miscellaneous Supplies ____ Add $70.00 Ea. for 13" to 14" Finished Length
Total System Charge ____ Add $90.00 Ea. for 15" to 16" Finished Length
Add $50.00 Ea. for 28 day rush delivery
Please include16.40 for UPS-Ground shipping. UPS 2 Day Air and Overnight shipping is additional.Hair Replacements. Credit cards will be charged 50% at the time of the order
and the balance when the order is shipped.
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To Pay By Credit Card - Visa____ MasterCard____ Amex____ Discover____ Call Me____
Exact Name on Card__________________________
Number____________________________ Expiration _______ Verification Code _____
Signature_________________________ Date__________________