Sign Up Sign Up Form ← Return to Forms To guarantee pickup, all requests need to be made by 9:00am the day of request Required fields are marked by an * Sign Up Form Name* PrefixMr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Best Contact Phone*Work PhoneMobile PhoneEmail Deliver toBilling AddressAlternate AddressAlternate Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Starch Preference*No StarchLightMediumHeavyShirt Preference*On HangerHand FinishedPayment MethodCredit Card (will call to confirm)CheckHow did you hear about us?Terms and Conditions*The following payment terms apply: Whether paying by check or credit card, a valid credit card number must be on file with Express Dry Cleaning. We accept Visa, MasterCard and American Express. Paying by Check: Payment must be made in full within 10 days of receipt of your order. If after 10 days your payment has not been received, your credit card will be charged for the entire balance due to date. A $35 fee will apply to any returned checks. Paying by Credit Card: We will bill the credit card we have on file on the day of delivery. Customers are liable for applicable collection costs. It is the responsibility of the customer to notify Express Dry Cleaning of any changes to billing or pick up and delivery information. I agree to be bound by the Payment Terms listed above and by all Terms & Conditions outlined in Express Dry Cleaning's General Policies. I hereby authorize the use of my Visa Card, MasterCard or American Express Card for payment of services rendered by Express Dry Cleaning. Release of Liability: Express Dry Cleaning adheres to all standards and policies set forth by the IFI. We inspect each garment prior to processing it for cleaning. However, we cannot assume any accountability for natural flaws, defects, or weaknesses in the materials which may result in but are not limited to tears, color loss, color bleeding, shrinkage, occurrence of holes in the fabric. The process of dry cleaning and laundering carries with it some inherent risks, which we can not guarantee against. Regardless of brand, condition prior to pickup or age of garment, Express Dry Cleaning’s total liability with respect to any damaged or lost garment shall not exceed ten (10) times the charge for cleaning of that garment.Yes, I agree.No, I don't agree.