Five Corners Cleaners: Register Form

For pick-up and delivery service register online. Our delivery van is on the road Monday and Thursday between 10:00 A.M. and 2:00 P.M. Your cleaning will be returned 3 working days after pick-up. You will receive two express bags into which you place your garments for cleaning. The bags will have an identification tag for your name, address, phone number and special instructions for the care of your clothes. We will determine a location on your premises to place your garments for pick-up and delivery. Method of payment will be by credit card, check or cash. We accept Visa, Discover and Master Card. If you are uncomfortable posting your credit card on the Internet simply call us and we will take your card number over the phone. WE THANK YOU FOR THE OPPORTUNITY TO SERVE YOU.

First Name *

Last Name *

Street Address *

City *

Zip

Phone *

Email Address

We deliver and pickup on Monday and Thursday. Which day you would like your cleaning pickup?

Pickup

Which day you would like your cleaning droped off?

Drop Off

Laundry Starch:

Laundry Packaging:

Hangers Boxed

Special Instructions:

Your charge card information is secure online. If you are more comfortable, call us directly at 630-469-2333

Payment

Card Type:

Card Number

Name as it appears on card

Credit Card No

Expiration Date:

Five Corners Cleaners. Would like to donate a portion of your dry cleaning bill to your favorite charity, school or not for profit organization. Please let us know who they are in the box below.

Named Charites Five Corners Supports

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