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Repair Services Can Be Paid On Line or You Can Print The Form Below and Fax, Email, Or Mail Your Order.
Please Print This Form and Return With Hair System. Please includes notes or markings for special attention areas. You may also pay online.
Name ___________________________________
Date _________________
Address _________________________________
City __________________________ State__________ Zip Code________ Country________
Area Code and Phone Number (____)______________ E-Mail Address_______________________
Contact Name _________________________
Short Description of System To Repair _______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Special Requests: ________________________________________________________________________ _________________________________________________________________________________________ ________________________________________________________________________________________
Repair Cost is $ + $10.00 shipping per unit: Longer lengths, Remy or Russian hair or replace lace front is additional cost -Total $________
* If you would like for us to charge your card once the product is received, 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. 4-6 weeks. No refunds
American Hair Imports, Ordering Dept.
47 Park Road, Suite A3
Pleasant Grove, Alabama 35127, USA
NOTE: These prices DO NOT include shipping. Please add an additional $9.95 for return shipment after repairs are completed.
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