The Dry Cleaner Pickup and Delivery Form * denotes Required Field Please fill in your cleaning preference: Shirts Hangers Boxed Starch Preference No Starch Light Starch Medium Starch Heavy Starch Repair Authorization of $20 or Less Yes No Email * Phone * Address * Address Street Street Address City City State/Province State/Province Zip/Postal Zip/Postal Pickup Location Notes (i.e., front porch, back door, garage, etc.) Delivery Location Notes (i.e., front porch, back door, garage, etc.) Special Instructions (i.e., front porch, back door, garage, etc.) Billing Information Name on Card Phone * Billing Address Billing Address Billing Address Billing Address City City State/Province State/Province Zip/Postal Zip/Postal Card Type Visa MasterCard American Express Other Credit Card Number CSV Code Expiration Date MM/YY The Dry Cleaner has my authorization to charge all of my cleaning related services to the credit card listed above. A copy of all charges will be attached to each order for my reference. Submit
