Stuy Wash N Dry Payment
Please complete this form to pay for your laundry online.
Customer Name
First Name
Last Name
E-mail Address
example@example.com
Billing Address
*
Street Address
City
State / Province
Postal / Zip Code
Driver/Folder Tip (You can indicate cash) Optional
*
Grand Total = Laundry Total + Tip
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( X )
USD
Description
Credit Card
Date
-
Month
-
Day
Year
Date
Signature
*
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Submit
Should be Empty: