|
Please fill in your contact information below |
|
Your Name: |
|
|
Origin Address: |
|
|
Destination Address: |
|
|
E-mail Address: |
|
|
Tel. Contact: |
Home: |
|
| |
Work: |
|
| |
Cellular: |
|
| |
Pager: |
|
| |
Alternate: |
|
|
Move Date: |
|
|
|
Type in the number of each item you want
to have moved in the QTY column |
| |
|
|
QTY |
C/F |
Total |
|
QTY |
C/F |
Total |
|
|
Appliances |
|
|
|
|
|
AIR COND/WINDOW |
|
20 |
|
Microwave
Stand |
|
15 |
|
|
AiR COND/Sm |
|
10 |
|
Refrigerator Lg |
|
60 |
|
|
Dishwasher |
|
20 |
|
Refrigerator Md |
|
45 |
|
|
Dryer |
|
25 |
|
Refrigerator Sm |
|
30 |
|
|
Freezer
Lg |
|
60 |
|
Sewing Machine Cabinet |
|
10 |
|
|
Freezer
Md |
|
45 |
|
Sewing Machine
Portable |
|
5 |
|
|
Freezer
Sm |
|
15 |
|
Trash Compactor |
|
10 |
|
|
Microwave
Oven |
|
5 |
|
Washing Machine |
|
25 |
|
|
Shop Vac |
|
5 |
|
Stackable Washer/Dryer |
|
35 |
|
|
Vacuum
Cleaner |
|
5 |
|
Dehumidifier |
|
5 |
|
| |
|
|
|
|
|
|
|
| |
| |
Bedroom |
|
|
|
|
|
Bunk Bed |
|
70 |
|
Waterbed Base |
|
10 |
|
|
Day Bed / Captain |
|
50 |
|
Full Bed |
|
60 |
|
|
King Bed |
|
80 |
|
Foot/Head Board |
|
10 |
|
|
Queen Bed |
|
70 |
|
Single Dresser |
|
30 |
|
|
Rollaway Bed |
|
20 |
|
Double Dresser |
|
40 |
|
|
Single Bed |
|
40 |
|
Triple Dresser |
|
50 |
|
|
Twin Bed |
|
60 |
|
Vanity Dresser |
|
20 |
|
|
Futon Lamp |
|
70 |
|
Vanity Bench/dresser |
|
3 |
|
|
Night Stand |
|
5 |
|
Chaise Lounge |
|
25 |
|
|
Trunk |
|
10 |
|
Cedar Chest |
|
10 |
|
|
Wardrobe Lg |
|
40 |
|
Foot Locker/Batchelor Chest |
|
8 |
|
|
Wardrobe Sm |
|
20 |
|
Chest of Drawers |
|
3 |
|
| |
|
|
|
|
|
|
|
| |
| |
Dining Room |
|
|
|
|
|
Harvest Bench |
|
25 |
|
Dining Table |
|
30 |
|
|
Buffet Base |
|
50 |
|
Dining Chairs |
|
5 |
|
|
Corner Cabinet |
|
40 |
|
Hutch |
|
3 |
|
|
China Cabinet |
|
40 |
|
Bakers Rack |
|
5 |
|
|
Microwave Stand |
|
40 |
|
Tea Cart |
|
1 |
|
| |
|
|
|
|
|
|
|
| |
| |
Nursery |
|
|
|
|
|
Baby Carriage |
|
2 |
|
Changing Table |
|
25 |
|
|
Bassinet |
|
15 |
|
High Chair |
|
35 |
| | |