Name *

First Name

Last Name

Phone *

(###)

###

####

Shoe Type *

Oxford

Loafer

Boot

Monk Strap

Other

Service Requested *

Essential Shine $45

Mirror Finish $75

Deep Restore $110

Add-On Service (Optional)

Mirror Shine Only +$30

Deep Clean (Saddle Soap) +$35

Lace Replacement +$15

Edge Recoloring +$20

Premium Shoe Bag +$20/pair

Cedar Shoe Trees +$30/pair

Preferred Return Date *

MM

DD

YYYY

Return Method *

Pickup

Shipping