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REFURBISHMENT
You can either printout this blank form to fill out and send in -or- you can input your information, click print and send in the printout. After filling out this form ship your shoes and this form to:
   Johnston & Murphy Refurbishment
   1101 63rd Avenue North
   Nashville, TN 37209

1. Shipping Address (No P.O. Boxes Please)
Name 
Company 
Address 
City 
State 
Zip 
Phone 
Date of Order 
Shoe Size 
Email Address 

2. Billing Address
Name 
Company 
Address 
City 
State 
Zip 

3. Method of Payment:
     American Express
     Discover
     Mastercard
     Visa
     JCB
Credit Card Number 
Credit Card Expiration (MM/YYYY) 
     Check (no COD)


4. Indicate Service:
Premium Service $115.00
Basic Service $90.00
Refinishing Service $30.00
Heels Only $25.00
Additional Improvements $25.00
Full Soles & Heels (Handmade shoes) $250.00
Other (describe)  
    


Unsure, please diagnose		  
Subtotal 
Your Local Sales Tax 
Total 
 



Please do not send shoe trees, shoe bags or shine cloths with your shoes.
EMAIL SIGN-UP   CATALOG REQUEST GIFT CARDS SPECIAL SERVICES CUSTOMER SERVICE AS SEEN IN ABOUT J&M STORE LOCATOR
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