EmailMe Form - DotMobile Client Intake Form

Primary Client Details

Please fill out as much information below as possible.

Full Name *

First Last

Email *

Home Telephone *

### - ### - ####

Cell (Text/Call)

### - ### - ####

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Event and Style Details

Please fill out the information about your event and your personal style preference.

Type of Event

Event date and time *

MM / DD / YYYY HH : MM AM/PM

Event Location & Town/City

Make-Up Look

Hair Styles

Additional Services Required

Trial Session & Payment Details

Do you require a trial session? *

Yes

No

Requested date and start time of trial session *

MM / DD / YYYY HH : MM AM/PM

Requested Trial Location

Trial can also be done at our salon location, Petite & Sweet Boutique, located at 4025 Dorchester Road in Niagara Falls

List name of each person requiring services and what services are required:
MH=Make-up & Hair
M=Make-up only
H=Hair only

* Bookings require a minimum of 3 people

If there are any changes please notify us immediately.

By submitting this form I have agreed to contract Dot Mobile to provide styling services as outlined in this agreement. *

I Agree