Contact Information Contact Information Items to Move Items to Move Contact Information Items to Move Contact Information Name E-Mail Phone Alt. Phone Address (Origin) Zip (Origin) Address (Destination) Zip (Destination) Approximate Distance (Orig - Dest) In Miles Anticipated Move Date Time Preference (Any Time) 8am-10am 10am-12pm (Noon) 12pm (Noon)-2pm 2pm-4pm 4pm-6pm (Other Time) Living Room Sofa Loveseat Hide-a-bed Sectional(# of pieces) Futon Keyboard/Stand Entertainment Center(s) Bookcase Recliner, Arm Chair Ottoman, Footstool Coffee or End Table Large Screen TV Television 27-36 Small TV 8-26 TV Stand Audio/Video Components Lamp or Picture DINING ROOM Dining or Kitchen Table Dining Chairs or Barstools China Cabinet(each piece) Buffet or Server Kitchen Stove or Oven Refrigerator or Freezer Washer or Dryer Microwave Microwave Stand Bedroom Bed (King or Queen) Bed (Full) Bed (Twin) Bunk Bed Waterbed Trundle Bed Head Board Foot Board Dresser Mirror (Detached) Chest of Drawers Armoire (Empty) Nightstand Trunk or Chest Crib, Changing Table Linear Ft. of Clothes (Hanging) Small Desk Office Office or Roll-Top Desk Desk Extension Desk Chair Credenza File Cabinet (2 Drawer) File Cabinet (4 Drawer) File Cabinet (Fire Proof) Conference Table Drafting Table Computer Desk Hutch Computer Components MISCELLANEOUS Boxes Over 50lbs (each) Boxes Under 50lbs (each) Glass Tops Glass Shelves Marble Tops Area Rugs Large Plant Bicycle Hall Tree BBQ Grill Patio Furniture Ironing Board or Vaccum Vanity Lawn Mower Metal Shelves Curio Cabinet Etagere/Baker’s rack Sewing Machine Additional items not listed above? Do you need our movers to disassemble/disconnect and reassemble/reconnect any of the items marked above with Additional circumstances How many flights of stairs at your origin? 1 Flight 2 Flights 3 Flights Elevator How many flights of stairs at your destination? 1 Flight 2 Flights 3 Flights Elevator Check boxes below that apply to your move Elevator at Origin? Elevator at Destination? Walk more than 100' at Origin? Walk more than 100' at Origin? Sloped path at Origin? Sloped path at Destination? Check boxes below that apply to your move Returning Customer Referred by Customer Google Search Facebook Apartment Guide Angies List Internet Yellow Pages TV One of Our Trucks Other Any Comments or Questions? SHOW SUMMARY Some required Fields are emptyPlease check the highlighted fields. Submit Previous Step Next Step
