Great Lengths Questionnaire

Be the next winner of a Great Lengths Hair Extension Service - just fill out the client questionnaire below!

You will win: A Great Lengths Service. Value $2200! Hair is not included. Price of hair is between $500 to $700, depends on the need. Service will be performed by our Great Lengths Certified Technician.

Rules:

1. Must be 18 and over to enter
2. Not for employees or family of Trendz
3. One per person
4. Service must be than before three months of winning
5. Not valid in conjunction with any other offer
6. Deposit for the price of the hair must be given before extension service
7. Service can be transferrable
8. Winner will be notified by e-mail only

WINNER WILL BE SELECTED BY JANUARY 31, 2008!!

Please tell us about yourself:
Full Name
Phone
Address
City
State / Zip
Email address
Gender	Female Male
Birthday	1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920
Please answer the following questions to help us better understand and serve your needs:
How did you hear of Great Lengths Services?
Web Site Newspaper Ad Referral Friend
How did you hear of Salon/Great Lengths Hair Extensions?
Newspaper Ad Referral Salon Web Site
What is your motivation for wanting Great Lengths Services?
Fuller Hair Longer Hair Highlights All Three
Have you ever worn hair extensions before? Yes No
If yes, when and what type?
During any of these services, did you experience excess hair loss or damage to your natural hair? Yes No
If yes, please elaborate:
Are you interested in Great Lengths as a long-term option for your hair?
Yes No Don't Know
Are you interested in Great Lengths to help "grow out" your hair from its present condiditon?
Yes No Don't Know
What is the longest your hair will grow monthly on its own?
1/4" 1/2" 1" 1.5" 2" Don't Know
When was the last time you let it grow on its own?
What was your reason for cutting it?
Damage Bad Haircut Change Style
What is your normal hair maintenance program? Please list all styling products and tools you use at home:
How often do you visit the salon for maintenance and touch up services?
Monthly Two Months Three Months Longer
How often do you like to change your style?
Monthly Every Three Months Yearly Longer
What is your long-term goal for your hair?
Length Fullness Stetics Other
Are you currently taking any medication(s) or under physician's care? If so, list medications:
Do you have any allergies (chemical, medications, substances or other)?
Yes No Don't Know
Are you currently experiencing an unusual amount of hairloss? If so, list reason:
Chemotherapy Stress Alopecia Areata Other
Special interests and hobbies:
Workout and sport activities:
Do you want to take before and after pictures?
Yes No
Can we announce your name as a winner on our web site?
Yes No
Please write questions or main areas of concern regarding this service: