Mail or Fax in your order

Print out the following order form and either:

1. Fax it to (501) 640-6519 or
2. Snail mail it to:
   longhairlovers.com, Inc.
   574 Woodland Dr.
   Circleville, OH 43113 USA
   

Total: ____________ + $8 ($12 to Canada, $25 global) shipping and handling = _____________

Name: _________________________

Email: _________________________

Company (optional): _________________________

Address: _________________________

City: _________________________

State: _________

Country: _________________________

Zip: _________

Phone: (___) ____ - ______

(  ) I am enclosing a check or money order for the total amount plus shipping and handling. Please note that we do not accept checks by fax, so if you are paying by check you must mail it in.
(  ) I want to charge this purchase to my Credit Card

Credit Card (check one):

____VISA
____MasterCard

Card Number: _________________________

Expiry Date: _________

Signature: _________________________

I authorize longhairlovers.com, Inc. to charge my credit card for $________.