Appointment Request Form

Hair Model Appointment Request

Let's get some more information so we can find the right collaboration opportunity.
Full Name *

First Name Last Name
Cell Phone *

Area Code Phone Number
E-mail *
What coloring results are you most interested in? *

I wanna be "BLONDE AF" Pastel Fantasy Colors Vibrant Fantasy Colors Dark Dimensional Colors Light Dimensional Colors Reds/Coppers Not Interested in Coloring
What hairstyles are you most interested in? *

Short/Classic Short/Textured/Edgy Medium/Classic Medium/Textured/Edgy Long/Classic Long/Textured/Edgy
Using as much detail as you can, please list all chemical and coloring services on your hair for the last 5 years: *
Please upload a current photo of your hair. *

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Please upload an inspiration photo, if you have one.

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What days work best for you? *

Monday Tuesday Wednesday Thursday Friday Saturday Sunday
What timing is best for you? *

Morning - 8am to 11am Midday - 10am to 3pm Afternoon - 2pm to 6pm Evening - 5pm or later
Is there any further scheduling information you'd like us to know?
I, the undersigned, understand that this is a discounted service (pricing to be determined and agreed upon prior to scheduling service) in return for Christine Rinehart, The Glass Menagerie, and potential affiliates to be able to take videos and photos that may include my face showcasing before/after as well as processing and technique. *

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Hair Model Appointment Request