Credit Card Fax Form

Good Hair Days® Inc.
73 Water St.
Leominster, MA 01453 USA

We accept AMERICAN EXPRESS, MASTERCARD, VISA and DISCOVER. Fax this form to the number listed below. Do not email this completed form. We shred this page once your order is processed.

If you prefer to call us with this information, you may reach us at 978-537-8915 or 888-445-5335. Thank you. Updated 2010

Name on Card

**Please print all numbers clearly **

Card No.                    -                    -                    -                    -

Expiration Date MM/YY                    /

CVV2 Security Code:

MC/VISA/DISCOVER= 3 digits on the back - AMEX= 4 digits on front

Billing Address for your credit card statement. If same as shipping address you entered on our order form, write SAME.

Postal Code

Email Address for questions/shipment notification

Comments

We will destroy this information once your order is processed.

Fax this form to 978-537-9426

International Customers: Dial 00 1-978-537-9426