Form 1

Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Laundry Pickup
Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Special Instructions
For Delivery or Wash

Schedule Pickup*

Schedule Return
Return date must be at least 24 hours after pickup

My Products

Pounds of Laundry

Hold is placed on credit card for estimated charge based on estimated weight. Hold will chbage to final charge after being weighed.

$2.50CAD Pounds
Item subtotal:$0.00CAD

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty: