Interested In*
First Name*
Last Name*
Address*
City*
State/Prov*
Zip Code*
Country
Salon Name*
Years In Business
Salon Owners Name
Salon Phone Number*
Web Site URL
Email Address*
Mobile Phone
Is this your home or salon address?SalonHome
Primary Client Age Group18 - 2526 - 3536 - 4546 - 5556 - 65Over 65Variety
Primary Job Title* OwnerManagerStylistNail TechnicianSkin Care ProfessionalMakeup ArtistMassage TherapistStudentSchool InstructorBooth Renter
How many chairs are in your salon?
Is your Salon Departmentalized?
If so, How many Stylists?
How Many Chemical Technicians?
Which services are offered on your salon menu? (Check all that apply)
Other Services
Number of Locations
If more than 1 location, how many would you like to certify?
Describe your Location Type* Destination (Drive up to Door)Mall or Outdoor Lifestyle CenterFranchiseStrip CenterSalon SuitesOther
Other Location Description:
What is your average Cut/Color ticket price?*
What is motivating your interest in Great Lengths Services?
If you currently offer Extensions, what is your primary brand?Hair DreamsSo-CapCinderellaDream CatcherSimplicityHot HeadsPlatinum SeamlessOther
Other Extensions Brands:
How many extension services do you perform in a 1 month period?1-34-67-910+None
How much do you charge for an extension service?
Full Head
Partial Length and Thickness
Non Chemical High/Low Lights
What do you like most about your current extension Brand?
What do you like the least?
Which retail line(s) does your salon carry?*
Other Retail Lines:
Which of the following describes why you carry your current retail lines? (Choose the top 3 answers)
Other Reasons:
Have you ever attended an academy class or certification to offer an exclusive service?YesNo
If yes, what kind of class?
Other Class:
Are you interested in becoming Great Lengths Certified? If so:
What is your 1st preferred city for attending classroom training?
What is your 2nd preferred city for attending classroom training?
How soon would you like to attend?
What type of eductaion do you value most?
Other:
What could a manufacturer provide to effectively drive your extension business?
Contact PreferenceAnyemailPostal mailPhoneFax
Referred By*
