Limit 1 garment per order. You must complete all boxes

My Order (not including tax):	Store My Garment $39.95 Store + Clean My Fur Coat $59.95 Store + Clean My Accessory $59.95 Store + Clean My Fur Trim $69.95 Store + Clean My Shearling $79.95 Store + Clean My Leather $79.95
E-mail address:
First Name:
Last Name:
Mailing Address:
City:
State:
Zip Code:
Daytime Phone:
Fur Type:	Mink Badger Beaver Broadtail Chinchilla Coyote Fisher Fitch Fox Lamb Leather Lynx Mink Muskrat Nutria Persian Rabbit Raccoon Sable Shearling Stone Marten Tanuki Tibetan Sable Other
Dollar amount of additional INSURANCE required (above the $500 included with this service):
Payment Information:	Visa® MasterCard®
Credit Card Number:
Expiration:	Month Year
My initials that I have read and accept the terms and conditions of my order:
Special Instructions (stains, repairs etc.)
If you would rather call in your order instead, that's easy too. Call us at 516-484-0630 or print and fax this page to 516-484-8136.
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