BASS RIVER SHOE REPAIR ORDER FORM
Print this form and put it in the box with your shoes. Use bubble wrap, tissue paper or newspaper to cushion your shoes and prevent movement in the box during shipping.
Daytime Phone: ______________________________________________
All prices given over e-mail or phone are subject to change depending on condition of shoes. We will confirm the price with you prior to charging your card.
VISA ____ MasterCard_____ Discover_____
Credit Card #__________________________________ Exp. Date______ CSC No. ____
Card holder name ________________________________________
Ship the items needing repair to:
Bass River Shoe Repair
146 Old Main Street
S. Yarmouth, MA 02664
THANK YOU FOR YOUR BUSINESS! We enjoy serving you!