Please print and complete this order form.

Hair By Mail
Order Form For Hair System (Repairs)
50% deposit needed, No Exceptions
Mail your order to: Hair By Mail,

1366 NE 163rd Street Suite #200
North Miami Beach, Florida 33162
Call Toll Free - 877-886-9045

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 __________________________________________
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Hair Type Desired: Human Hair___ Synthetic Fiber___
Style: Please indicate one:
Hair Parting Styles
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)
Head Map
2
LEFT
TEMPLE
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4
BEHIND
LEFT EAR
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2
RIGHT
TEMPLE
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 4
BEHIND
RIGHT EAR
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1
FRONT
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3, 5
TOP
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6
BACK
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Special Requests: ________________________________________________________________________
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Quantity Ordered                  
_____   Additional charge for longer finished lengths.
Major (like new) Repair                     Charges double for Oversize Systems and Full wigs

209.00   $______   Add 15.00 Ea. for 6" to 7" Finished Length

Minor (almost new) Repair $99.00 $______   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 business rush
Please include 
16.40 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.
 
To Pay By Credit Card - Visa____  MasterCard____  Amex____  Discover____ Call Me ____
Exact Name on Card__________________________
Number____________________________    Expiration______  Verificaion Code ______
Signature_________________________    Date__________________