Wig Application Form

If you would prefer to send us in your application by mail, Please click here to print out our wig application form to send to us by post at the following address:

Send to:

Hair We Share
4 Expressway Plaza Suite LL14
Roslyn Heights, NY 11577

Wig Applicants First Name (required)

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Wig Applicants Last Name (required)

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Your Email (required)

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If under 18, please state the name of the legal guardian (required)

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Address (required)

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Required Documents (Please Check All That Apply)

Email required documents to Care@hairweshare.org

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Profile/Photo Release


By submitting this form I verify that I am the recipient or LEGAL PARENT or GUARDIAN of the Hair We Share recipient and understand the terms described to me. I authorize Hair We Share, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Hair We Share may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, and web content. I have included my NAME AND PHONE NUMBER for verification.

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Please provide personal anecdotes (i.e. interests, hobbies, and other “colorful” attributes that help describe recipients’ situation, personality, perspective): Feel free to attach additional information.

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My name and phone number are provided below for verification and will be considered as my electronic signature upon the submission of this form.

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