(408) 268-3143
   

 

 
 
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Customer Info
First Name:
Last Name:
Phone:
Example: (925) 123-4567
How did you find out about our service?
How do you like your laundry starched?
None Light Medium Heavy
Which day(s) of the week would you like your clothes picked up & delivered? (Usual turn around time is 2 - 3 days)
     
Pick-up Day
 
Delivery Day
 
     
Delivery Address
Address Line 1:
Address Line 2:
City:
State:
 
Billing Info (if different from above)
Company Name:
Mailing Address Line 1:
Mailing Address Line 2:
City:
State:
Zip:
Payment Preference



Credit Card Info
We will charge your card end of each month for the amount serviced during that month. The billing summary will be included along with your last delivery for that month.
Credit Card Type
Credit Card Number Exp. Month Exp. Year
Special Notes

 

 

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