Hair Weaving Consultation Form
Kleopatra's The Master In Hair Weaving

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Date:____/_____/____



1. Name: _____________________________________________________

2. Address: ___________________________________________________

3. City, State: ________________________________________________

4. Zip Code: __________

5. Telephone: ____-_______-_______

6. E-mail address: ____________________________________________

7. What is the texture of your hair?__________________________

8. Do you like your hair texture?_____________________________

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8.b What texture would you like?______________________________________
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9. What would you like to acheive in your hairweaving design?

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10, What hairweaving techniques have you tried?

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10.b. Which technique are you interested in? _____________________________
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10.c. Describe what you would like to achieve in techniques and in style:________
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11. Have you ever worn a hairweaving before?

__________________________________________________________________

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12. Is this your first time having a Hair Weave?

yes___ no____

12.b. If Yes, How was your last experience?

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13. What is your budget for your hair illusion? ___________________
(This will help us to assess which technique that will best fit your goals & budget.)

14. What color is your natural hair?
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15. What color do you want your hair extensions to be?
(Note: Check our color chart for color codes, write the closest color.
If color is not listed please describe to the best of your abilities.)

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16. Do you have a photo of yourself that you could send to us?
(Photo: Is not necessary, but will give us more accurate analysis for you
to observe your profile and color variations.)

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17. How much of your natural hair do you want woven?
(Describe to the best of your ability of what area of your hair
that you want to be woven, Such as: back, front, etc.)

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18. What is the length that you want your extensions to be?
(Prices may vary due to length depending on your request of desire needed.)

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19. Write any information about yourself that you may want us to know.
Please write any additional information that you feel that
will help us in your consultation.

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20. How did you hear about us:

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21. How may we improve our services with you:
_____________________________________________________________________
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Note: Consultation fees or investment will apply towards your beauty services
when you schedule your appointment at our facilities. Otherwise there is no refund,
Your fees covers services of your technical analysis, time, administration with
our technical consultant giving you answers plus your options for your design.

To requesting a consultation by regular mail print out this form and
include a photo of yourself, a color sample, plus hair styles from magazines
or photos of what you want to achieve as far as hair style. Send your information
along with consultation fees. Make money orders (U.S.C) payable to: Jeane Kilpatrick
in memo write Kleopatra's Hair Weaving Consultation.

Mail to: Kleopatra's Inc.
Request Consultations
3896 Dewey Avenue Suite #5309
Rochester, N.Y. 14616

Headquarters
585-415-7786
e-mail: kleopatrasecrets@msn.com
e-mail: Kleopatrasecrets@gmail.com

Copyrights Exclusive of Kleopatra's Inc. 2005 Consultation Form For Hairweaving