Order Form

Select "print" in your browser.
Fill out the form, then return to

A-Plus Hair Systems
71 Carlson Ridge Rd
New Milford, CT 06776
Color Hair Sample

Please attach here a minimum of 1/2" hair sample wrapped in tape

Name: ________________________________________

Street: ____________________________ Apt.: _______

City: ___________________________ State: ___________ Zip: _________-_________

Phone: ( _____ ) _______-_______________

Qty. Description Unit PR Total
       
       
       
       
       
Subtotal
 
Tax 6% (CT Only)
 
Ship / Handling
$12.00
Express (add $20)
 
Total
 

Please send check or money order payable to A-Plus Hair Systems, or credit card information to:

71 Carlson Ridge Rd
New Milford, CT 06776		 credit cards.JPG (15174 bytes)

Credit Card Information:

Card #: ______________________________________

Exp. Date: ______-_______

Signature: _______________________________

Custom Orders
For Hair Density please use: "H" for Heavy, "M" for Medium and "L" for Light
For Type of Wave please use: "S" for Straight, "SW" for Slight Wave and "C" for Curly
For Front Hair Line please use: "S" for Scallop, "L" for Lace and "U" for Under Vented

Qty. Description Hair Density Type of Wave Front Hair Line Price
           
           
           
           

860-355-7048