Shoe Repair Order Form

     First Name: 
      Last Name: 

        Address: 
        Address: 
           City: 
 State/Province: 
Zip/Postal Code: 
        Country: 

          Phone: 
            Fax: 
 E-Mail Address: 

Please select item(s) you wish to order, enclose a pre-paid return shipping label with your order or add the cost of return shipping to the amount due with your order. Then print two copies of this form, one to send to us and the other copy for your records. Mail completed order form with payment (checks payable to Shoestring Exchange) to:
Shoestring Exchange Shoe Repair
32 Fickett Street
South Portland, ME 04106
Tel: (207) 767-3558
If you have any questions please contact us.