Step 1: Donor Information
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Step 2: Receive and Keep Your ID Number
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Step 3: Process Complete
Please Make Sure Your Hair Meets Our Hair Donation Requirements
:
Click here to check our donation guidelines
.
· Hair must be a minimum of twelve (12) inches and clean and dry before sending. Hair must NOT be chemically treated or permanently dyed.
· Only one email address can be used per donation. If you have any questions, please contact our office at 440-333-4433 before submitting this form.
Donating Hair *
Donor Information
First Name *
Last Name *
Adults' Email (please do not use your salon or stylist's email.) *
Phone Number (555-555-5555)
Address *
Address 2
City *
State (XX) *
Zip *
Country *
Please select one
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas (the)
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory (the)
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands (the)
Central African Republic (the)
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands (the)
Colombia
Comoros (the)
Congo (the Democratic Republic of the)
Congo (the)
Cook Islands (the)
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic (the)
Denmark
Djibouti
Dominica
Dominican Republic (the)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (the) [Malvinas]
Faroe Islands (the)
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories (the)
Gabon
Gambia (the)
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (the)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Johnston Island
Jordan
Kazakhstan
Kenya
Kiribati
Korea (the Democratic People's Republic of)
Korea (the Republic of)
Kuwait
Kyrgyzstan
Lao People's Democratic Republic (the)
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia (the former Yugoslav Republic of)
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands (the)
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Midway Islands
Moldova (the Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands (the)
New Caledonia
New Zealand
Nicaragua
Niger (the)
Nigeria
Niue
Norfolk Island
Northern Mariana Islands (the)
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines (the)
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation (the)
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Southern Rhodesia
Spain
Sri Lanka
Sudan (the)
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan (Province of China)
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands (the)
Tuvalu
Uganda
Ukraine
United Arab Emirates (the)
United Kingdom
United States
United States Minor Outlying Islands (the)
Upper Volta
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Viet Nam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Age of Donor *
In Honor, In Memory, In Celebration of Donation
Check this box if this donation Is In Honor, In Memory, or In Celebration of:
Dedication Type
Type of Dedication:
In Honor of
In Memory of
In Celebration of
Dedication Name
How did you hear about Wigs For Kids?
Click all that apply
Salon
Great Clips
Google
Social Media
Previous Donor
Friends and Family
Medical Professional
Other
The children we serve would love to hear from you. If you would like to share a message of support, or share why you are making your donation today, please tell us below:
Donation Requirements
Does your donation measure 12 inches or more? *
Yes
No (If No ‘Please consider growing longer before donation’)
Is your hair free of chemical processing (dyes/perm)? *
Yes
No (If No ‘Your hair will not be useable until all the dye or perm has grown out’)
Are You Ready To Cut Your Hair Today? *
Yes
No
Please consider making a financial donation to cover the production costs of producing a wig.
Would you consider holding a fundraiser for Wigs For Kids *
Yes
No
I would like to make a monthly financial contribution to sponsor a child.
You will receive a thank you via email. Check here if you would also like to receive a thank you postcard in the mail.
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