5 Star Fluff and Fold
Personal Laundry Service
Order Number:
Name
*
First Name
Last Name
Date of Pick Up
*
-
Month
-
Day
Year
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:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Date of Delivery
*
-
Month
-
Day
Year
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1
2
3
4
5
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9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Instructions:
*
Process Normally
Fold All Items
Hang Shirts/Pants/Skirts/Bras
Hot Wash
Cold Wash
Warm Wash
Dry on Low
Hang/Air Dry
Bleach Whites
No Bleach
Use 5 Star Supplies
Customer Supplied
No Softener
Use Free & Clear
Use Oxi
Socks - Roll
Socks - Fold
Weight - Bag #1
Weight - Bat #2
Weight - Bag #3
Weight - Bag #4
Number of Pounds
*
Price Per Pound
*
Extra Charges
Tip - Thank you!:
Total of this Order:
Total Amount Due:
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