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<title>Order From: Yamanouchi Trading</title>

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<td>&nbsp;</td>

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<td><font size="2">Please make your order from the form below.</font></td>

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<td>&nbsp;</td>

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<form method="post" action="http://www.good-hair.com/cgi-bin/form/form.cgi">

<input type="HIDDEN" name="mailto" size="-1" value="info@good-hair.com">

<input type="HIDDEN" name="Order details" size="-1" value="order">

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<td><font color="#ffffff" size="2"><strong>Products ordered</strong></font></td>

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<td bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Ghassoul-Clay&nbsp;Soap</font></td>

<td><font size="2">Qty:&nbsp</font><input name="Soap Qty" type="text" id="Medicated Shampoo　order" value="" size="2"><font size="1">&nbsp（2,800yen&nbsp;Tax included）</font></td>

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<td width="57%" bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Thymuskin Shampoo</font></td>

<td width="43%"><input name="Shampoo Qty" type="text" id="Shampoo order" value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">（14,700 yen Tax included ）</font></td>

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<td bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Thymuskin Medicated Shampoo</font></td>

<td><input name="Medicated Shampoo Order qty " type="text" id="Medicated Shampoo Order Qty" value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">15750 yen Tax included）</font></td>

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<td height="0" bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Thymuskin Hair Conditioner</font></td>

<td><input name="Thymuskin Hair Conditioner Qty" type="text" id=" Thymuskin Hair Conditioner Qty " value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">（12600 yen Tax included）</font></td>

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<td bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Thymuskin Treatment</font></td>

<td><input name=" Thymuskin Treatment Qty" type="text" id=" Thymuskin Treatment Qty” value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">（23000 yen Tax included）</font></td>

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<td width="57%" bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Wooden Comb with handle</font></td>

<td width="43%"><input name=" Wooden Comb with handle Qty" type="text" id=" Wooden Comb with handle Qty" value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">10500 yen Tax included</font></td>

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<td bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Wooden Comb Arched</font></td>

<td><input name=" Wooden Comb Arched Qty" type="text" id=" Wooden Comb Arched Qty" value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">（6850 yen Tax included）</font></td>

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<td width="57%" bgcolor="#b9a384"><p align="right"><font color="#ffffff" size="2">Squalane Oil towel(derived from Aizame Shark Liver oil extract) </font></td>

<td width="43%" height="4"><input name=" Squalane Oil towel(derived from Aizame Shark Liver oil extract) Qty" type="text" id=" Squalane Oil towel(derived from Aizame Shark Liver oil extract)" value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">(945 yen tax included)</font></td>

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<td bgcolor="#b9a384" align="right"><font color="#ffffff" size="2"> Long Towel</font></td>

<td height="2"><input name="Long towel Qty" type="text" id="Long Towel Qty" value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">(1365 yen tax included)</font></td>

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<td width="57%" bgcolor="#b9a384" align="right"><font color="#ffffff" size="2">Spiritual Drops (gel)（30g）</font></td>

<td width="43%"><input name=" Spiritual Drops (gel)（30g）Qty" type="text" id=" Spiritual Drops (gel)（30g）Qty" value="" size="2"><font size="2">Qty&nbsp;</font><font size="1">(15000 yen tax included)</font></td>

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<td>&nbsp;</td>

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<td width="40%" align="right"><font size="2">Payment Method：</font></td>

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    <td width="626" height="146"><form action="https://www.paypal.com/cgi-bin/webscr"

    method="post">

      <input type="hidden" name="cmd" value="_s-xclick"><input type="hidden" name="encrypted"

      value="-----BEGIN PKCS7-----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-----END PKCS7-----

"><p><input

      type="image" src="https://www.paypal.com/en_US/i/btn/x-click-but6.gif" border="0"

      name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> </p>

      <p><font face="Trebuchet MS">Payments for your order can be made here via PayPal.</font></p>

      <p><font face="Trebuchet MS">If you'd like to pay by some other means, please request in the message box.</font></p>

      <p><font face="Trebuchet MS">Credit Card payments will be available shortly.</font></p>

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<td width="40%" align="right"><font size="2"First Last Name：</font></td>

<td width="60%"><input name="Name" type="TEXT" id="Name" size="50" style="width:280px"></td>

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<td align="right"><font size="2"> Zip Code：</font></td>

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<td align="right"><font size="2"> Address：</font></td>

<td><input name="State" type="TEXT" id="State" size="50" style="width:280px"></td>

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<td align="right"><font size="2">City/Town：</font></td>

<td><input name=" City/Town " type="TEXT" id=" City/Town " size="50" style="width:280px"></td>

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<td align="right"><font size="2">Telephone Number：</font></td>

<td><input name=" Telephone Number " type="TEXT" id=" Telephone Number " size="50" style="width:280px"></td>

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<td align="right"><font size="2">E-mail：</font></td>

<td><input name="email" type="TEXT" id="email" size="50" style="width:280px"><br><font color="#FF0000" size="1">（An error will occur if no email address is entered）</font></td>

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<td>&nbsp;</td>

<td><font size="1">Please add any special details or requests here</font><br><textarea name="Questions" cols="50" rows="5" id="　Questions　" style="width:280px"></textarea></td>

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<td align="center"><br><input name="SUBMIT" type="SUBMIT" id="SUBMIT" value="Submit Order">&nbsp;&nbsp;<input name="RESET" type="RESET" id="RESET" value="　Clear　"><br><br></td>

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<td bgcolor="#b9a384"><img src="img/copy.gif" width="400" height="20" border="0"></td>

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<td height="50" bgcolor="#ffcccc">&nbsp;</td>

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