Shoe Repair
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Complete this order form. Upon clicking the “Submit Order” button, your information will populate the address fields at the UPS website for label printing

Print and retain a copy of your order form including ticket and tracking numbers (next page); include a copy of the order with your footwear inside the box

Include check or payment information

Print the UPS label and tape to a box (next page)

Drop your order at any UPS box or pick-up location.

Call toll-free

with any questions.


CUSTOMER INFORMATION ("*" indicates required field)

First Name*:

Last Name*:

Address Line 1*:

Address Line 2:


Postal Code*:

Daytime Phone*: (5558882222)

Evening Phone:


SERVICE OPTIONS (select one)

Western Boots with Leather Sole $90
English Paddock Boots $70
English Tall Boots $95

Tall Boot Resole and Zipper Replacement $150
YES, I authorize Replacement Components if original is unavailable. Please do not call me.
There is a $20 shipping and handling charge for each package. Multiple shoes can be included per shipment.


Cedar Shoe Trees $25
Cedar Boot Trees $30
Birkenstock Cork Footbed $40
Military Dual Density Gel Insole $15
Military Boot Care Kit $20
Rough Out Leather Shampoo $8
Rough Out Leather Renewal Mojave $8
Rough Out Leather Renewal Tan $8
Black Edge Dressing $8
Leather Protector $6
Odor Away Fresh Scent $8
Shoe Cream (specify color) $6
Leather Conditioner $6
Suede and Nubuck Shampoo$8
Extra Laces (specify color & length) $5
Cedar Shoe Trees Luxurious Shoe Cream Military Boot Care Kit Military Dual Density Gel Insole
Rough Out Leather Conditioner Rough Out Leather Renewal Mojave Rough Out Leather Renewal Tan Edge Dressing Black Odor Away Fresh Scent Black Edge Dressing Laces



Retailer Where Purchased:
Retailer Account Number:
Ship To: Consumer Retailer

PAYMENT OPTIONS ("*" indicates required field)


Money Order

No American Express please

(not required if Check or Money Order)
Name on Credit Card

Credit Card Number


Credit Card Security Number (3 digits)

Customer Signature
By clicking here, I authorize NuShoe to charge my credit card once my order has gone into repair.

NuShoe, Inc., 8534 Siempre Viva Road, San Diego, CA 92154 | © 1994 – 2013 NuShoe™ NuCraft™ | All Rights Reserved.


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