Click Printer Friendly Format Button Below. Print and fax to 901-937-4805;or mail to 1856 Vanderhorn, Memphis, TN 38134
___HOME DELIVERY/CREDIT APP ___CREDIT APPLICATION ONLY(store charge)
PERSONAL INFORMATION:
Last Name________________________________
First Name_______________________________
Spouse’s First Name_______________________
Address_____________________________Suite/Apt#______
City ___________________ State______Zip________
Home Phone_________________ Cellphone_______________
Work Phone_________________
E-Mail Address:__________________________@_______.com
Employer ________________________________
Spouse’s Employer _______________None___
SHIRT LAUNDRY PREFERENCES:
On Hangers _____ No Starch_____
Folded(boxed)____ Light Starch_____ Heavy Starch______
Delta Airlines® SkyMiles® #
#__ __ __ __ - __ __ __ - __ __ __
Payment by AmEXP,VISA® Mastercard®
__________ -__________ -__________ - __________ ________
Visa,Mastercard,AmExp number Exp. Date
(may be phoned in separately)
Your credit card will be charged in the first week of the following month for previous months charges.
Note: Tickets on clothes picked up in previous months are billed to your credit card on first week of the following month. It is understood that this is a 30 day account. Any balance over 30 days (due to expiration or over credit limit on credit card) is considered past due and is subject to service charge of 1.5% per month on the past due balance only. If credit is granted, the above terms are deemed to be accepted. It is further agreed that if any amount due must be placed with an attorney for collection or if collection is made through bankruptcy or probate proceeedings, all court costs and a reasonable attorney's fee will be added to the total amount due.
__________________________ ________________
Signature Date
__________________________________________________________________________
If you currently use a Bensinger's store, please circle one.
4715 Poplar 1789 Kirby Pkwy 1803 Union
1315 Ridgeway 7580 W. Farmington 1605 Germantown@Dexter
5167 Poplar 9155 Poplar Ave 7945 Winchester@Hacks
l255 N Byhalia(collierville)
