| First Name* | 
          
          
            | Last Name* | 
          
           
            | Address* | 
          
          
            | Address Line Two | 
          
            
            | City* | 
          
           
            | Delivery Area* 
       
			
            Not sure? Don't see your area?
 Call and ask!
 1-888-559-5539
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            | Zip Code* | 
          
          
            | Mobile Phone #* Please include area code.
 (This will be your account number.)
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            | E-mail* Confirm Email:
  by  (Required) Use your "BACK ARROW" after confirming, to Finish Sign-up Process.
 Confirming opens in a new window via Constant Contact.
 Email is our Primary Delivery Information Method to keep you updated.
 
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            | Your area days (See chart)
 
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            | Shirt Preference* | 
          
           
            | Starch Preference* | 
		  
		  
		  
          
           
            | Please Pick Up My Clothes Here:* (i.e., front porch, garage, back porch, etc.)
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            | Please Deliver My 
            Clothes Here:* (i.e., inside screen door, garage, porch, etc.)
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            | FIRST Pick-Up Order Scheduling:
			
           Please select either A or B: 
 A: Please pick-up my FIRST order on (select a Tuesday or Friday)*
 
 (mm/dd/yyyy)
 
 B:	  Not sure at this time, for my FIRST order
 I will "Schedule a Pickup" online when ready.
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            | Future Pickup Scheduling:
			  
			
			
			
			
			
			* Our driver automatically stops every Tuesday & Friday for Arsenal 201. 
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	 | PERSONAL OPTIONS: | 
		  
		    
            | Yes, Please provide me with a complimentary "Wreath Holder" to hang over my door so that the driver can hang my returned order on it. (Homeowner customers only) Yes  No
 
 A complimentary Purple laundry bag will be provided unless you choose the Go Green bag option
 Yes  No
 
 Yes, Please provide me with a reusable "Go Green" garment bag for a small fee of $10.95 + tax -
 What's This?
 Yes  No
 
 I would like to recycle my hangers. Please provide me with a free hanger caddy - What's This?
 Yes  No
 
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	 | WASH N' FOLD: | 
		  
	 
            | Yes, I will be needing Wash N' Fold service for my underwear, socks, towels, etc. and agree to the charge of $2.49* per pound plus the cost of a Wash n' Fold bag of $9.95. New customer's first Wash n' Fold order will receive $10 off. Minimum order charge $29.95
 (* Blankets, comforters and bed linens are not processed by the pound. )
   Please select below:
 Scented detergent
 Unscented detergent
 Fabric softener
 Unscented Fabric Softener
 
 No, I am not interested in laundry by the pound at this time
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	 | BILLING INFORMATION: | 
    
   
     | Name on Card:* 
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     | Card Type:* 
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     | Credit Card Number Only:* (No CVV code required)
 
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     | Expiration Date* (MM/YY): /
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            | Comments or Special 
            Requests Use this area to tell us special requests
 *Required Fields 
             | 
          
          
            | How did you hear about us? Door Hanger
 Internet
 Already Deliver to Location
 Noticed Delivery Van
 Info from Route Driver, Ben
 Info from Route Driver, Michael
 Friend, relative or referral
 Visited Store First
 Store Employee
 
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	 | TERMS & CONDITIONS: | 
	
		 
		| I have read and agree to all of the Four Seasons 
        Dry Cleaners terms and conditions related to delivery services. Form 
        will not be sent and new service cannot begin unless "I AGREE" is checked. | 
          
          
            | After the form is submitted please check your email for instructions on how to send in your first dry cleaning order. 
 Please type the text you see in the image
 
   
 
   
 
 
            
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