1. Contact Information
fields with an * are required
Mr.
Ms.
Mrs.
First Name:
*
Middle Name:
Last Name:
*
Building/Community Name:
Home Address:
*
City/State/Zip Code:
*
Phone:
*
Cell Phone:
Email:
*
Date of Birth:
2. Route Service
Pick up at:
Front
Side
Back
Other
If other, please specify:
Drop off at:
Front
Side
Back
Other
If other, please specify:
Will Call:
Other special delivery instructions:
3. Cleaning Instructions
Shirt:
Hanger
Fold
Starch:
No
Light
Medium
Heavy
Creases/Pleats:
Yes
No
Other special care instructions:
4. Billing Information
Card Type:
Primary Card Number:
Expiration Date:
5. Submit your order
* I authorize Plaza Ford-Ideal Laundry & Dry Ceaners to charge my Mastercard, VISA, American Express, or Discover card in accordance with said terms. I hereby certify that the information in this credit application is true and correct.