Pick-Up & Delivery Registration / Credit Authorization

PICK-UP & DELIVERY REGISTRATION / CREDIT AUTHORIZATION

Name

Pickup Address

Delivery Address

Phone

Cell

Laundered Shirts

HANG

FOLD

Instructions

SERVICES REQUIRED

ON-GOING SERVICE (2x per week)

CALL-IN SERVICE (will call for pickup)

INSTANT SERVICE GARMENT BAG

# of Bags (2 in 1 for $15, 2 for $25)

XPRESS SERVICE BAG

IF YOU CHOOSE TO HAVE REGULAR ON-GOING SERVICE, WE ASK THAT YOU PLEASE CONTACT US IF YOU WILL BE AWAY OR OTHERWISE NOT REQUIRING OUR SERVICES BEFORE YOUR NEXT SCHEDULED PICKUP.

I hereby give the staff of Gellibrand’s Excellence in Dry Cleaning to process the cost of cleaning my garments.

Card #

Expiry Date

PLEASE ADVISE US IMMEDIATELY IF ANY OF YOUR ACCOUNT INFORMATION SHOULD CHANGE, CARD LOST / STOLEN OR YOUR EXPIRY DATE CHANGES. TELEPHONE OR ADDRESS CHANGE.

FAX: (780) 489-4000

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