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 SHIPPING  INSTRUCTIONS

1.  COMPLETE SHIPPING FORM BELOW

2.  INCLUDE THIS FORM WITH YOUR ORDER

USA SHIPPING ONLY. WE DO SHIP APO/AFO.
WE ACCEPT VISA, MC, PAYPAL.
~~NO CHECKS.~~

 

      

MAIL TO:

 

HIGH STREET SHOE REPAIR

 

 

233 HIGH ST. NE

 

 

SALEM, OR  97301

 

              SIGNATURE CONFIRMATION AVAILABLE FOR $5 CHECK HERE 

NAME 

SHIPPING ADDRESS 

CITY    STATE  ZIP CODE 

PHONE 

EMAIL 

BILLING ADDRESS  SAME      DIFFERENT    

REPAIR ORDER


  #1    STYLE    COLOR REPAIR COST

           REPAIR      DR. MARTEN SOLES  1705   4014   OTHER


  #2     STYLE    COLOR REPAIR COST

           REPAIR      DR. MARTEN SOLES  1705   4014   OTHER

PAYMENT

  PAYPAL- PLEASE SEND ME A PAYPAL INVOICE

CALL ME FOR MY CREDIT CARD INFORMATION

VISA      MC   CARD #       

EXP DATE MM/YY              CVCC#