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 SHIPPING  INSTRUCTIONS

1.  COMPLETE SHIPPING FORM BELOW

2.  INCLUDE THIS FORM WITH YOUR ORDER

SORRY...   NO INTERNATIONAL SHIPPING...  WE DO SHIP APO/AFO

 

      

MAIL TO:

 

HIGH STREET SHOE REPAIR

 

 

233 HIGH STREET NE

 

 

SALEM, OR  97301-3643

 

              SIGNATURE CONFIRMATION AVAILABLE FOR $3 CHECK HERE 

NAME 

SHIPPING ADDRESS 

CITY    STATE  ZIP CODE 

PHONE 

EMAIL 

BILLING ADDRESS  SAME      DIFFERENT    

REPAIR ORDER

  #1    BRAND    COLOR REPAIR COST

           REPAIR      BLUNDSTONE SOLES  1705   1716   1752

                               SAS SOLES                      1030  1328  SOLETECH           

                               SOLES & HEELS                                   

                               LIFT         SIZE OF LIFT

                               COWBOY BOOT ZIPPERS

  #2     BRAND    COLOR REPAIR COST

           REPAIR      BLUNDSTONE SOLES  1705   1716   1752

                               SAS SOLES                      1030  1328  SOLETECH           

                               SOLES & HEELS                                   

                               LIFT         SIZE OF LIFT

                               COWBOY BOOT ZIPPERS

 

PAYMENT

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CALL ME FOR MY CREDIT CARD INFORMATION

VISA      MC   CARD #       

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