1 Info2 Dry Cleaning3 Laundry Customer InformationName First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Email* Phone*Pick up Time : HH MM AM PM Pick up Date Date Format: MM slash DD slash YYYY Dry CleaningShirt Price: $1.75 Quantity: Option Light Starch Heavy Starch T-Shirt Price: $1.99 Quantity: Option Light Starch Heavy Starch Pants Price: $2.25 Quantity: Option Light Starch Heavy Starch Jeans Price: $2.25 Quantity: Option Light Starch Heavy Starch Shorts Price: $2.25 Quantity: Option Light Starch Heavy Starch Dress Price: $3.99 Quantity: Fancy Dress Price: $4.99 Quantity: Blouse Price: $2.25 Quantity: Sweater Price: $2.25 Quantity: Jacket Price: $4.50 Quantity: Fancy Jacket Price: $5.50 Quantity: Jersey Price: $3.25 Quantity: Overalls Price: $4.00 Quantity: Fur Coat Price: $30.00 Quantity: Handkerchief Price: $1.99 Quantity: Leather Pants Price: $40.00 Quantity: Leather Shirt Price: $40.00 Quantity: Leather Skirt Price: $40.00 Quantity: Jump Suit Price: $4.00 Quantity: Napkins Price: $1.49 Quantity: Sheets Price: $7.99 Quantity: Pillow Case Price: $2.99 Quantity: Pillow Price: $4.99 Quantity: Scrub Bottom Price: $1.99 Quantity: Scrub Top Price: $1.49 Quantity: Bra Price: $1.99 Quantity: Chair Cover Price: $1.99 Quantity: Blankets Price: $4.99 Quantity: Wedding Dress Price: $80.00 Quantity: LaundryLab Coat Price: $3.99 Quantity: Wash & Fold Price: $0.79 Quantity: Leather Price: $40.00 Quantity: Apron Price: $1.99 Quantity: Coat Price: $6.99 Quantity: Vest Price: $2.50 Quantity: Hooded Jacket Price: $2.99 Quantity: Letterman Jacket Price: $40.00 Quantity: Tie Price: $2.00 Quantity: Army Jacket Price: $2.50 Quantity: Bedspread Quilt Price: $8.99 Quantity: Option Full/Small Queen King Table Cloth Price: $8.99 Quantity: Option Medium Large Sweat Pants Price: $2.50 Quantity: Long Sleeve Shirt Price: $1.99 Quantity: Fancy Dress - Long Price: $55.00 Quantity: Fancy Blouse Price: $3.49 Quantity: Subtotal $0.00 Tax $0.00 Total $0.00 Credit Card Card Details Cardholder Name CAPTCHA
