B. Nelson Shoe Repair ORDER FORM
Mail this order form to: 140 East 55th St. New York, New York 10022

Name:         Date:
Shipping Address:
City:       State:         Zip:
Daytime Phone:  Daytime Fax (opt.): 
Email (opt):

Repairs for Birkenstock shoes:
Heels
$15.00 pr.
Resole: (w/minor corkwork)
$30.00
Resole: (w/major cork buildups)
$40.00
Resole: super grip sole
$35.00
Resole: hand stitched
$55.00
Resole: Ontario/Trekking shoes
$37.00
Reline: suede
$30.00
Reline: leather
$37.00
Reline and resole
$55.00
Replace Buckles
$3.50 ea
Replace back straps
$20.00 pr
Recrafting: (replace footbeds and soles)
$60.00
Replace toe area only
$25.00
Replace uppers: (select styles only)
$60.00
ADD: $7.95 for shipping
METHOD OF PAYMENT:
  AMEX   Mastercard   Visa   Check   Money Order
Credit Card #:
Expiration: Month       Year