LET’S MAKE THIS MOVE SMOOTH Name * First Name Last Name Email * Phone (###) ### #### Prospective Move Date * Availability of date is based upon company's schedule. MM DD YYYY Pick Up - Address Please list address in which you are relocating from. Address 1 Address 2 City State/Province Zip/Postal Code Country Drop Off - Address Please list address in which you are relocating to. Address 1 Address 2 City State/Province Zip/Postal Code Country Housing Type Apartment Condo House Dormitory Other Please list furniture and amount * For example: Couches (#) Beds (#) Table (#) Side and Coffee tables (#), ETC How Many Bedrooms? 1 Bedroom 2 Bedroom 3 Bedroom 4+ Bedroom Does your home have have stairs? This includes basement stairs, two level homes, and apartment buildings. Yes No Please list how many stories/flights of stairs below Include basements/ Apartment Buildings Are elevators at your facility? Yes No Are there any antique items in your home? If so, please list below. Parking Availability (Pick Up Location) * Please choose the most accurate option. Drive Way Parking Lot (approx 10-15ft) Parking Lot (15ft+) Parking Availability (Drop Off Location) * Please choose the most accurate option. Drive Way Parking Lot (approx 10-15ft) Parking Lot (15ft+) Hallways and Doorways Small Standard Size Large Mixture Would you be comfortable with a in person or virtual walk through? Yes No I hereby authorize that all the information provided above is true and accurate to the best of my knowledge. I understand that any changes to this information may affect the final quote and services rendered by the moving company. * Please Type Name and Date Thank you!
