The Original Hair Cinch Order Form
Customer Information Date:____________
 
 
 
 
 
 
Name
Address
City, State,Zip
Daytime Phone
E-mail Address
Credit Card : Visa, M.C. , American Express, Discover or by check#______

Card #: ____________________________________ exp.date:_____

Signature:__________________________________________

Leather

color

Bead

Color

Bead

Style

# of

Beads

Quantity
Price
Total$
              
                   
                 
                   
                
               
                  
              
              
             
1- Choose from every catagory for each Cinch requested. 2. Complete the form including daytime phone number and e-mail address
Merchandise Total
 
Shipping and Handling Add $3.95 for 1st Cinch Add $1.00 for each additionalCinch  
N.C. Residents add %7 sales Tax  
Transaction Total
 
This Form May be duplicated or printed out and used for mail orders. Please allow 2-4 weeks shipping for mail order purchases. Send to: Hair Cinch Fashions Inc, P.O. Box 520, Arden, N. Carolina 28704