1640 S. Congress Ave., Suite 104
Palm Springs, FL 33461
(561) 963-1677 or Fax:(561) 963-9914
TOLL FREE INFO 1-888-896-1588

LOCKS OF LOVE is a charity that provides hairpiecesto financially disadvantaged children under the age of eighteen with medical hair loss


HAIR DONATION GUIDELINES

HAIR DONATION

Please fill this form out, print it and send it in with your hair donation.
Please measure your ponytail(s) and write the length(s) in inches on the outside of the re-sealable bag.

Your Name:  
Address:Apt:Age:(If minor)input type="text" size="5" maxlength="20" name="age">
City:State:Zip:
Fax:Email
Address:
Daytime
Phone:
Evening
Phone:
Country:
How Did You Find Us?

Please specify how you would like to contribute to Locks of Love.

Enclosed is my hair

Please fill in any other interests, questions, or comments in the box below: