Application
To ensure your child’s free wig application is processed quickly we require a $25 application fee. Processing your child’s application helps us eliminate spam applications.
Full Name
*
First Name
Last Name
Your Childs Full Name
*
First Name
Last Name
E-mail
*
Yexample@example.com
Phone Number
*
-
Area Code
Phone Number
What is your child’s race?
*
Black or African American
White
Hispanic
Asian
Biracial
What is your child’s Gender
*
Male
Female
N/A
Please provide any additional information such as your child’s age & etc…
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Application processing fee
$
25.00
To ensure quicker turn around times & to eliminate spam applications, we require a 25$ application fee.
Total
$
0.00
Payment Methods
Credit Card
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Submit
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