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Form Test
ACMEAdmin
2020-12-11T02:55:57-07:00
Step 1 of 2 - Host Info
Step 1 of 3 - Host Info
Step 1 of 4 - Host Info
Step 1 of 5 - Host Info
Step 1 of 6 - Host Info
Step 1 of 7 - Host Info
Number of guests
*
One
Two
Three
Four
Five
Six
Other
Please enter the amount of guests beyond six
*
Additional details or notes for your party
Please complete the rest of the form and we will contact you right away to get the details for each guest over the phone.
Your name (or name of the host, if different)
*
First
Last
Please select your service
*
Please select a service
Mani Regular Polish-$50
Mani Gel Polish-$50
Mani DIP-$65
Regular Polish Pedi-$60
Gel Pedi-$70
Regular Polish Mani/Pedi-$100
Regular Polish Mani/Gel Pedi-$100
Gel Mani/Regular Polish Pedi-$100
Gel Mani/Gel Pedi-$100
DIP Mani/Regular Polish Pedi-$110
DIP Mani/Gel Pedi-$120
Men's Manicure-$35
Men's Pedicure-$60
Men's Mani/Pedi-$85
Mani Dip
Open to Select Your Dip Colors
*If you are supplying your own dip colors, you may skip this color selection.
Select up to 3 Dip colors. Then collapse this area or simply scroll down to the next. Zoom into any color using the magnifying icon for a closer view and to see the color code.
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Section Break Dip End
Gel Pedi
Gel Mani
Gel Mani & Gel Pedi
Open to Select Your Gel Colors
*If you are supplying your own gel colors, you may skip this color selection.
Select up to 3 Gel colors. Then collapse this area or simply scroll down to the next. Zoom into any color using the magnifying icon for a closer view and to see the color code.
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Section Break Gel End
Regular Polish Mani
Regular Polish Pedi
Regular Polish Mani & Pedi
Open to Select Your Regular Polish Colors
*If you are supplying your own regular polish colors, you may skip this color selection.
Select up to 3 Regular Polish Colors, then collapse this area or simply scroll to the next. Zoom into any color using the magnifying icon for a closer view and color code.
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Section Break Regular Polish End
Please select your service add on
If Interested, please select an add on
Set of professional tools-$25
Extension Tips-$30
Ombre'-$25
French tips-$20
Nail Art-$20
Acrylic removal-$25
Hard Gel removal-$25
Paraffin Wax-$25
Toe- Regular polish change-$25
Toe- Gel polish change-$35
Please add any special notes.
Step 2 of 3 - Second Guest
Step 2 of 4 - Second Guest
Step 2 of 5 - Second Guest
Step 2 of 6 - Second Guest
Step 2 of 7 - Second Guest
Second Guests Name
*
First
Last
Please select a service for the second guest.
*
Please select a service
DIP Mani/Gel Pedi-$110-Best Value
Mani Regular Polish-$50
Mani Gel Polish-$50
Mani DIP-$60
Regular Polish Pedi-$60
Gel Pedicure-$70
Regular Polish Mani/Pedi-$100
Gel Mani/Regular Pedi-$100
Gel Mani/Gel Pedi-$100
DIP Mani/Regular Polish Pedi-$100
Men's Manicure-$35
Men's Pedicure-$60
Men's Mani/Pedi-$85-Best Value
Service add on for second guest
If Interested, please select an add on
Set of professional tools-$25
Extension Tips-$30
Ombre'-$25
French Tips-$20
Nail Art-$20
Acrylic removal-$25
Hard Gel removal-$25
Paraffin Wax-$25
Toe Regular polish change-$25
Toe Gel polish change-$35
Add color code(s) and notes for 2nd guest. Put N/A if no color(s) or notes.
*
Upload a picture of your second guest's preferred color and/or nail style.
Optional
Accepted file types: jpg, jpeg, png, gif.
This field is hidden when viewing the form
Select Your Dip Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
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This field is hidden when viewing the form
Select Your Dip Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
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This field is hidden when viewing the form
Select Your Dip Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Dip Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Dip Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Select Your Regular Polish Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Select Your Regular Polish Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Select Your Regular Polish Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Select Your Regular Polish Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Select Your Regular Polish Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Select Your Regular Polish Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Select Your Regular Polish Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Gel Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Gel Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Gel Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Gel Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Gel Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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This field is hidden when viewing the form
Select Your Gel Colors
p-8
p-9
p-10
p-10
p-11
p-12
p-13
p-14
p-15
p-16
p-17
p-18
p-19
p-20
p-21
p-22
p-23
p-24
p-25
p-26
p-27
p-28
p-29
p-30
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Step 3 of 4 - Third Guest
Step 3 of 5 - Third Guest
Step 3 of 6 - Third Guest
Step 3 of 7 - Third Guest
Third guests name
*
First
Last
Please select a service for the third guest.
*
Please select a service
DIP Mani/Gel Pedi-$110-Best Value
Mani Regular Polish-$50
Mani Gel Polish-$50
Mani DIP-$60
Regular Polish Pedi-$60
Gel Pedicure-$70
Regular Polish Mani/Pedi-$100
Gel Mani/Regular Polish Pedi-$100
Gel Mani/Gel Pedi-$100
DIP Mani/Regular Polish Pedi-$100
Men's Manicure-$35
Men's Pedicure-$60
Men's Mani/Pedi-$85-Best Value
Service add on for third guest
If Interested, please select an add on
Set of professional tools-$25
Extension Tips-$30
Ombre'-$25
French Tips -$20
Nail Art-$20
Acrylic removal-$25
Hard Gel removal-$25
Paraffin Wax-$25
Toe Regular polish change-$25
Toe Gel polish change-$35
Add color code(s) and notes for 3rd guest. Put N/A if no color(s) or notes.
*
Upload a picture of your third guest's preferred color and/or nail style.
Optional
Accepted file types: jpg, jpeg, png, gif.
Step 2 of 5 - Fourth Guest
Step 3 of 5 - Fourth Guest
Step 4 of 5 - Fourth Guest
Step 4 of 6 - Fourth Guest
Step 4 of 7 - Fourth Guest
Fourth guests name
*
First
Last
Please select a service for the fourth guest.
*
Please select a service
DIP Mani/Gel Pedi-$110-Best Value
Mani Regular Polish-$50
Mani Gel Polish-$50
Mani DIP-$60
Regular Polish Pedi-$60
Gel Pedicure-$70
Regular Polish Mani/Pedi-$100
Gel Mani/Regular Polish Pedi-$100
Gel Mani/Gel Pedi-$100
DIP Mani/Regular Polish Pedi-$100
Men's Manicure-$35
Men's Pedicure-$60
Men's Mani/Pedi-$85-Best Value
Service add on for fourth guest
If Interested, please select an add on
Set of professional tools-$25
Extension Tips-$30
Ombre'-$25
French Tips-$20
Nail Art-$20
Acrylic removal-$25
Hard Gel removal-$25
Paraffin Wax-$25
Toe Regular polish change-$25
Toe Gel polish change-$35
Add color code(s) and notes for 4th guest. Put N/A if no color(s) or notes.
*
Upload a picture of your fourth guest's preferred color and/or nail style.
Optional
Accepted file types: jpg, jpeg, png, gif.
Step 2 of 6 - Fifth Guest
Step 3 of 6 - Fifth Guest
Step 4 of 6 - Fifth Guest
Step 5 of 6 - Fifth Guest
Step 5 of 7 - Fifth Guest
Fifth guests name
*
First
Last
Please select a service for the fifth guest.
*
Please select a service
DIP Mani/Gel Pedi-$110-Best Value
Mani Regular Polish-$50
Mani Gel Polish-$50
Mani DIP-$60
Regular Polish Pedi-$60
Gel Pedicure-$70
Regular Polish Mani/Pedi-$100
Gel Mani/Regular Polish Pedi-$100
Gel Mani/Gel Pedi-$100
DIP Mani/Regular Polish Pedi-$100
Men's Manicure-$35
Men's Pedicure-$60
Men's Mani/Pedi-$85-Best Value
Service add on for fifth guest
If Interested, please select an add on
Set of professional tools-$25
Extension Tips-$30
Ombre'-$25
French Tips-$20
Nail Art-$20
Acrylic removal-$25
Hard Gel removal-$25
Paraffin Wax-$25
Toe Regular polish change-$25
Toe Gel polish change-$35
Add color code(s) and notes for 5th guest. Put N/A if no color(s) or notes.
*
Upload a picture of your fifth guest's preferred color and/or nail style.
Optional
Accepted file types: jpg, jpeg, png, gif.
Step 2 of 7 - Sixth Guest
Step 3 of 7 - Sixth Guest
Step 4 of 7 - Sixth Guest
Step 5 of 7 - Sixth Guest
Step 6 of 7 - Sixth Guest
Sixth guests name
*
First
Last
Please select a service for the sixth guest.
*
Please select a service
DIP Mani/Gel Pedi-$110-Best Value
Mani Regular Polish-$50
Mani Gel Polish-$50
Mani DIP-$60
Regular Polish Pedi-$60
Gel Pedicure-$70
Regular Polish Mani/Pedi-$100
Gel Mani/Regular Polish Pedi-$100
Gel Mani/Gel Pedi-$100
DIP Mani/Regular Polish Pedi-$100
Men's Manicure-$35
Men's Pedicure-$60
Men's Mani/Pedi-$85-Best Value
Service add on for sixth guest
If Interested, please select an add on
Set of professional tools-$25
Extension Tips-$30
Ombre'-$25
French Tips-$25
Nail Art-$20
Acrylic and Hard Gel removal-$25
Paraffin Wax-$25
Toe Regular polish change-$25
Toe Gel polish change-$35
Add color code(s) and notes for 6th guest. Put N/A if no color(s) or notes.
Upload a picture of your sixth guest's preferred color and/or nail style.
Optional
Accepted file types: jpg, jpeg, png, gif.
Last Step - Appointment Details
Email
*
Cell Phone
*
Preferred date
*
We will contact you to confirm your requested date and time. Periodically your date and time may conflict with an appointment already set.
MM slash DD slash YYYY
Preferred appointment time
:
Hours
Minutes
AM
PM
AM/PM
Address of appointment
*
Street Address
Address Line 2
City
ZIP Code
How did you hear about Essential Mobile Nails?
Please select one
Customer Referral
Google Search
Instagram
Yelp
Facebook
Name of the Essential Mobile Nails customer who referred you.
Please let us know the full name of the Essential Mobile Nails customer so we can thank them.
First
Last
Phone
This field is for validation purposes and should be left unchanged.
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