| First Name: * |
Last Name: * |
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| Email Address: * |
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| Address: * |
Fax No: |
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| City: * |
Zip Code: * |
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Appointment Request: *
(select appointment date and time)
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| Please select the service(s) you want
from the list below: * |
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Threading |
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Eyebrows+ upper lips |
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Full Face |
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Hair cut |
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Hair color |
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Hair spa |
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Shampoo+ style |
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Highlights |
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Perm |
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Japanese hair straightening |
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Henna |
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Head oil massage |
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Facial |
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Deep cleansing |
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Waxing |
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Full waxing(Full Arms+ Full legs+ underarms) |
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Partial waxing |
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Eyebrows |
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Other |
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| How would you like to be contacted to confirm your
appointment? * |
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Telephone
Email
Fax |
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| Comments? |
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| If referred, who referred you to Angel Hair & Beauty Salon? |
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| Is this your first visit to Angel Hair & Beauty Salon? |
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Yes
No |
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| How did you learn about Angel Hair & Beauty Salon? |
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Found On Web |
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Radio |
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Email |
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Magazine/Newspaper |
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Word of Mouth |
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| Others, Please specify: |
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