Authorization Form

Form
Name*

First NameLast Name
Shipping Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Order # *
Agreement to authorize this purchase*

Yes
I agree that this purchase is 100% legit and I am the owner of the card being used to make this purchase *

Clear
I agree that Magnify Hair Co. is not responsible for any lost, damaged, or stolen goods during mail transit*

Clear
I agree to the no refund or exchange policy *

Clear
Should be Empty: