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Order Form
Print this form, fill it out, then mail to us along with your
check
or money order. Credit cards cannot be used with this form.
(Information included on this form is not released to anyone else)
To get help filling out this form click
here.
PERSONAL INFORMATION
Date:_________________
Referred by: ______________________________
1. Name:____________________________________________________________
Mailing
Address:__________________________________________________________
City: __________________ State: _______ Zip Code:
_________
Country: ______
Reference (who this system is
for):_______________________________________
2. Telephone: (____)
______________ Email: _____________________________
HAIR REPLACEMENT SYSTEM INFORMATION
3. System Type
[ ] 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.
[ ] 1/4" pull-through space
[ ] 1/2" pull-through space
[ ] 3/4" pull-through space
4. Hair Type Synthetic: ______________ % Human: ______________
%
5. Size
[ ] Tape Template enclosed, or
[ ] Side to side :______________ inches. Front to
back: ______________ inches.
PLEASE NOTE: If you want to use an extended wear
method of attachment, (for example, 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.
If you can, send us an old system that fits. We
will copy the size and send it back with
your new hair system.
6. Part/Style: Please check one -
7. Color - Please take large samples. Attach hair samples
here with tape.
|
|
2
LEFT
TEMPLE
.
.
. |
4
BEHIND
LEFT EAR
.
.
. |
2
RIGHT
TEMPLE
.
.
. |
6
BACK |
3, 5
TOP |
1
FRONT |
4
BEHIND
RIGHT EAR |
8. Curl
[ ] Straight (no body) - 40 mm. - human or synthetic
[ ] Soft Movement - 30 mm - human or
synthetic
[ ] Light Wave - 25 mm - human or synthetic
[ ] Medium Wave - 22mm - human or synthetic
[ ] Loose Curl - Strong Wave - 15mm -human or synthetic
[ ] Tight Curl - 10mm - human or synthetic
[ ] Loose Afro - 8 mm. - human or synthetic
[ ] Afro - 2-6 mm - synthetic only
9. Universal Density:
[ ] Extra Light
[ ]
Light [ ] Light to Medium
[ ] Medium (100%)
[ ]
Medium to Heavy [ ] Heavy
[ ] Extra Heavy
10. Special Requests and Additional Items: List in #7
below:
ORDERING INFORMATION
1. __________ How many
Systems on this order?
2. $___399.00_ Custom
System Price
3. $_________ Total
of line 1, times line 2
4. $_________ Longer
length charges
5. $_________
Shipping - $8.00 U.S., $18.00 Canada, or $31.00 International
6. $_________
Subtotal - add lines 3 + 4 + 5
7. $_________
List additional items and total price here - Example: Protek, Base Type,
Venting, CK Hair Solutions repair, supplies, etc.
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
(If you need additional space, please use the back of this form.)
8. $_________ Add
lines 6 + 7
9. $_ 100.00_
Subtract
this amount if this is a custom system reorder within one year.
10. $_________ Subtotal
11. $_________ CA residents add
8.5% sales
tax.
12. _________ Total
amount due
PLEASE NOTE: Full payment is required at the time the
order is placed.
Please indicate the type of payment enclosed:
[ ] Check [ ] Money Order
Expect custom system delivery in approximately 6-8 weeks.
Thank you for your order!
Remember!
Attach sample(s) of your hair, and include a Tape
Template or old
System, if any, along with the order form and payment, and mail to:
CK Hair Solutions
3602 S Peninsula Dr., Ste 202
Port Orange, FL 32127
Please
contact us if you
have any questions.
Copyright © 2000. CK Hair Solutions. All rights reserved.
Revised: January 5, 2006
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