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Application Type

       

HOME DELIVERY/CREDIT APP

CREDIT APPLICATION ONLY(store charge)

First Name:

Last Name:

Spouse's First Name:

Address:

SUITE/APT #:

City:

State:

Zip Code:

Main Phone:

Secondary Phone:

Work Phone:

E-mail Address:

Employer:

Spouse's Employer:

On Hangers

Folded (Boxed)

Starch:

       

None

Light

Heavy

If you currently use a Bensinger's store, please select one:

{embed captcha}
Enter Captcha here:  
                       
               

You 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.

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Bensingers Home Delivery Account Application

 

Fill out the form below and a representative of Bensinger's Cleaners will contact you for billing information to finalize your application.

You can also Click Here to download a printable version of the credit application to fax or mail.

   
                                     

Application Type

       

HOME DELIVERY/CREDIT APP

CREDIT APPLICATION ONLY(store charge)

First Name:

Last Name:

Spouse's First Name:

Address:

SUITE/APT #:

City:

State:

Zip Code:

Main Phone:

Secondary Phone:

Work Phone:

E-mail Address:

Employer:

Spouse's Employer:

On Hangers

Folded (Boxed)

Starch:

       

None

Light

Heavy

If you currently use a Bensinger's store, please select one:

Verification Code
Enter Captcha here:  
                       
               

You 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.