The Romeo Villager Cleaners love customers
Please complete the following form and submit or print and drop it off at your next visit.  (* required information)

Your Name

Name*     

Address

Home         Office
Street*
City*
State* Michigan
Zip Code* *If your area is not in the list, please call us. We'll be happy to assist.
Phone*
  ex) 3334441111    Secondary  
E-mail

Additional information

Are you a new customer? Yes         No
Starch Preference None        Light       Medium     Heavy
Packaging Preference Hanger     Box

The location where to leave your clothes

Front Door          Garage: Please provide key# below.      Other: Please specify location below


* First pickup date (starting date):     ex) mm/dd/yy

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