Online Questionnaire & Signing Form

Complete this form so we can calculate your total, recommend a deposit, and generate an invoice-style PDF you can save and email to driplegend2631@gmail.com.

Full Legal Name *

Facility / Organization

Phone *

Email *

Type of Service *

Number of Clients (5–10) * $25 per haircut. Minimum 5, maximum 10 unless arranged.

Total Miles (round trip) * Use Google Maps from either 72301 or 72335, then enter total miles. Mileage charged at $1/mile.

Closest Base ZIP *

West Memphis 72301 Forrest City 72335 Not sure

Deposit Option *

$25 – 1-week hold $50 – full appointment hold

Planned payment method *

Service Location Address * Include facility name, full address, city, state, and ZIP.

Notes / Special Instructions

Digital Signature (type full legal name) * Typing your full legal name acts as your digital signature for the Service Agreement, Waiver & Consent, and Proposal.

I confirm that I have reviewed the Dripology Cuts LLC Guide & Agreement, Service Waiver, and Service Proposal. I understand haircuts are $25 each (5–10 clients), mileage is $1 per mile, and payment is due the same day services are completed unless other arrangements are made.

After downloading your PDF, email it to driplegend2631@gmail.com and then complete your Square booking.