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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.
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