Name: ________________________________________

Street Address: __________________________________

City:_________________________Zip: ______________

Home Phone: ____________________

Work Phone: ____________________

E-mail: _________________________

Shirt Starch:

 

 

Credit Card Information

__ Mastercard __ Visa __ American Express

Card # ____________________________

Expiration Date:_________

I authorize Bowen Cleaners to automatically bill my credit card.

Signature: ______________________________________

Or call with credit card information

(252)321-2911 x204 - Jennifer Tripp

Or Fax

(252)756-6763

Please indicate the best place for us to check for pickups

and make deliveries out of bad weather.