*Name First/Last

Organization

Street Address

Address (cont.)

City

State/Province

 
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
*E-mail

* Required Fields

Where did you hear about us? 

If another web site which one?

Where are you moving from?

Where are you moving to?

When are you moving?

Tell us about your residence:		  
 What floor are you on?
 Is there an elevator?
 Is there parking outside for a truck?
How long is the walk from your front door to where the truck would park?
How many steps are there?
   

Any thing else we might need to know?

Who's going to pack? If you pack everything or just the cartons we can save you money.

 

PLEASE TYPE IN THE BOX HOW MANY YOU HAVE OF THE FOLLOWING ITEMS

LINEN/CLOTHING:

Clothes boxes

    

    

LIVING ROOM:

Book cartons (small boxes)

Computer equipment

TV cabinet

TV small

TV large

Coffee table

Loveseat

Table lamp

Floor lamp

Desk large

Desk small

Rocking chair

Arm chair

Book case small

Book case large

Sofa

    

    

DINING ROOM:

Dining Chairs

Boxes for china

Pictures small

Mirror / pictures Large

Drop-leaf table

Rugs small

Rugs large

China Hutch

Dining Table

    

    

BEDROOMS:

Wardrobes large

Wardrobes small

Night tables

Dressers

Bunk bed

King bed

Queen bed

Single bed

    

    

KITCHEN:

Corner cabinet

Stool

Kitchen chairs

Kitchen table

Vegetable bin

 

BASEMENT & GARAGE:
(Excluding Cars)

Ironing board

Roof rack / bike carrier

Shelving

Work bench

Childs wagon

Tool chest

Sewing machine

Power tools

Filing cabinet four draw

Filing cabinet two draw

Childs bike

Adults bike

Wheelbarrow

Garden umbrella

Garden table

Outdoor slide / swing set

Riding lawn mower

Push lawn mower

Ladder small

Ladder large

Garden bench

Hose

Garden tools

Lawn chairs / folding chairs

BBQ

Vacuum cleaner

Dehumidifier

Piano upright

Piano / keyboard

Music cabinet

    

    

BATHROOMS:

Clothes rack

Clothes basket

   

    

MISC.:

Bench

Misc. boxes large boxes

Chaise lounge

Chest of drawers

Suitcases

Golf clubs

Footlocker

Fan

Grandfather clock

  Anything else you need to take that we have not listed?

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Send mail to mark@deliver-usa.com with questions or comments about this web site.
Copyright © 2000 DELIVER USA INC
Last modified: April 04, 2005