|
*Your Name:
|
|
|
|
*E-Mail Address:
|
|
|
|
Telephone (Home):
|
|
|
|
Telephone (Work):
|
|
|
|
*Approximate Moving Date:
|
|
|
|
*Moving From:
|
*Elevator
Yes
No
*No. Flight Stairs
|
|
|
*Moving To:
|
*Elevator
Yes
No
*No. Flight Stairs
|
|
|
*Who Packs For You?:
|
Moving Ahead
You
|
|
|
*Who Supplies Cartons?
|
Moving Ahead
You
|
|
|
*No. of Bedrooms:
|
|
|
|
*Approximate No. Cartons:
|
|
|
|
*Paintings Smaller than 2 X 3:
|
|
|
|
*Paintings Larger than 2 X 3:
|
|
|
|
*Glass Smaller than 2 X 3:
(furniture tops/shelves)
|
|
|
|
*Glass Larger than 2 X 3:
(furniture tops/shelves)
|
|
|
|
*Piano:
|
|
|
|
*List Special Items or Antiques:
|
|
|
|
How Did You Hear About Us
|
|
|
|
|
|
|
|
|
|
|
