Date of Move 

* Type of Move  Local Move Long Distance International Move Office Move Storage Installation Piano Car - Describe in Comments Boat - Describe in Comments Other - Please Describe --> Other: 

* FROM City:  State:  Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Zip Code:

* To       City:  State:  Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming    Zip Code:

Pick-up Location Info:

* Type of residence  Please Select  House Town House Apartment Condo High Rise Office

What floor, if moving from a condo or high-rise: 

How many flights of stairs? (approx. 12 steps per flight)  Please Choose  0 1 2 3 4 5 or more

Is there a reserved elevator available?  Please Select  Yes No

How close to the door of the building can we park our truck?  Please Choose  within 100 feet 100 to 200 feet 200 to 300 feet 300 to 400 feet over 400 feet

Do you require us to do any Packing?  Please Select  Yes No

Delivery Location Info:

* Type of residence  Please Select House Town House Apartment Condo High Rise Office

What floor, if moving to a condo or high-rise: 

How many flights of stairs? (approx. 12 steps per flight)  Please Choose  0 1 2 3 4 5 or more

Is there a reserved elevator available?  Please Select  Yes No

How close to the door of the building can we park our truck?  Please Choose  within 100 feet 100 to 200 feet 200 to 300 feet 300 to 400 feet over 400 feet

Please provide your contact information:
Company Name
* Name
* E-mail
Phone (main)
Phone (alternate)
Street Address
* City, State, Zip
FAX
Best time to call (if necessary)  Please Select  Morning Afternoon Evening
Please contact me as soon as possible.

Please List ALL Items for an Accurate Quote (Type in the Number of Items)

Living Room	Portable TV (10" - 19")	Entertainment Ctr.
Sofa/Loveseat	Console TV (20" - 27")	TV Stand
Sofa pit pieces	30" - 35" TV	Stereo (Pieces)
Hide-a-Bed	36" - 40" TV	Bookcase
Large Chair	Big Screen TV (proj)	Sofa Table
Ottoman	HD TV	Coffee / End table
Bedroom(s)	Armoire/Wardrobe	Vanity
Queen/Full/Twin Bed	Small Mirror	Dresser
King or Water Bed	Large Mirror	Small Dresser
Platform Bed	Hutch Mirror	Cedar Chest
Head/Foot Board	Portable Sewing Machine	Night Stand
Lrg Head/Foot Board	Cabinet Sewing Machine	Clothes (per foot)
Kitchen/Laundry		Washer/Dryer
Refrigerator/Freezer	Microwave	Ironing Board
Stove/Oven	Microwave Stand	Vacuum
Dining Room
Dining Table	Buffet Server	Dining Chairs
Dinette/Breakfast Table	China Cabinet	Credenza
Office
Executive Desk	Computer Desk	2-3 Dwr File Cab
Office Desk	Writing Desk	4-5 Dwr File Cab
Desk Return	Sm Bookcase	Lateral File Cab
Garage/Outdoor
BBQ Grill	Patio Table	Bike
Lawn Mower	Patio Umbrella	Lawn Chairs
Tool Chest	Picnic Table	Rakes/Tools
Work Bench	Bench	Trash Cans
Boxes & Misc.
Small Boxes	Plant (Sm)	Spinet Piano
Large Boxes	Plant (Lg)	Console Piano
Wardrobe Boxes	Hall Tree	Upright Piano
Glass Top (Sm)	Storage Cabinet	Grandfather Clock
Glass Top (Lg)	Lamp	Folding Table
Marble Top (Sm)	Pole Lamp	Curio/Eterage
Marble Top (Lg)	Bakers Rack	Side-by-Side Chest
Crib	Stair Stepper	TV Trays
Futon & Frame	Small Chair	Area Rug
Bridge Bed
Trundle/Day Bed	Disassemble/Assemble	Extra Stop
Please enter any additional furniture here:
Enter any additional Comments here: