Shoe Repair Order Form

     First Name: 
      Last Name: 

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

          Phone: 
            Fax: 
 E-Mail Address: 
Payment Method: Check: Money Order

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.

Description Qty Cost
Men's Dress Full Soles & Heels $45.00
Men's/Women's Rubber sole guards $20.00
Men's Dress Half Soles & Heels $40.00
Men's Rubber Heels $15.00
Men's Combination Heels $15.00
Men's Full Leather Heels w/ metal insert $20.00
Men's Casual/Work Shoes/Boots Rubber Soles $45.00
Men's Work Boots Rubber Soles/with new mid soles $50.00
Men's Work Boots Half Sole & Heels $40.00
Men's Western Boots Full Soles $50.00
Men's Western Boots Half Soles & Heels $45.00
Women's Dress Half Soles & Heels $35.00
Women's Rubber Heels (Small) $10.00
Women's Rubber Heels (Medium) $12.00
Women's Rubber Heels (Large) $15.00
Women's Combination Heels $15.00
Women's Casual/Walking Shoe Rubber Soles $40.00
Women's Work Boots Rubber Soles $45.00
Women's Work Boots Half Soles & Heels $40.00
Women's Western Boots Full Soles $50.00
Women's Western Boots Half Soles & Heels $45.00
Leather Sole Toe Tips $10.00/pair
Heel Savers $4.00/pair
Shoe Liners $8.00/pair
Heel Pads $5.00/pair
Restitching Soles $10.00/pair

Sub Total: $
Total Order: $
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