Instant Evaluate
920 East Semoran Blvd
Casselberry, Fl. 32707
Fax: 407-834-2207
Salon Service Order Form
- Please complete one form per Salon -
Franchisee Information:
First Name   *
Last Name   *
Total # of Salons Owned 
Salon Information:
Region# (first 3 digits of license #) *
   Salon # (remaining digits of license #) *
POS Software *
Salon Name (Location) 
How many stations in this salon? 
Salon Address     City
State       Zip
                 Email  *
- Service Order Terms -
Monthly pricing per salon
Fees paid by credit card
   $9 service charge per month
   45 fee per phone survey
   10 fee per Internet survey
   $24 Start-up Package includes: Mirror Clings, 1 Door Sign and 1 Price Board Sign.
  • Credit Card billed monthly, after service is provided.
  • One month of service ($9) billed in advance.
  • One time charge for Start-up Package billed immediately.
  • Salon may cancel service at any time with 30-day written notice.
  • Each owner will receive an individual username and password to view their salon service reports from the Internet.
Billing is through Regional Office (No credit card required)
Name on Card   *
   Credit Card Type   *
Billing Address   *
Expires   *
Card Number  *
Questions and Comments:
The following terms and conditions apply to this agreement.
  * Instant Evaluate may discontinue service due to non-payment.
* Each party confirms that it has full power and authority to enter into and perform this Agreement.
  I agree to all terms and conditions specified in the agreement above.