LONG FORM FOR PRICING

Name:
Telephone:
E-mail Address:
Moving From:
Moving To:
Tentative Move Date:
Tentative Delivery Date:
Floors at Origin:
Floors at Destination:
Elevator?:
Number of Rooms:
Total Square Feet (Estimated):

In the section below, please identify the number of each type of item you wish to move:
Living and Family Rooms   Chair, Straight or Rocker Lawn Mower, Hand
Bar, Portable Chaise Lounge Lawn Mower, Power
Bench, Fireside Desk, Small Lawn Mower, Riding
Bookcase Vanity Leaf Sweeper
Bookshelves Double Dresser Child's Slide
Chair, Arm Night Table Child's Gym
Chair, Occasional Rug, Large or Pad Swings
Chair, Overstuffed Rug, Small or Pad Picnic Table
Chair, Rocker Wardrobe, Small Picnic Bench
Chair, Straight Wardrobe, Large Rocker, Swing
Clock, Grandfather     Roller, Lawn
Day Bed Nursery   Rug, Large
Desk, Small Bathinette Rug, Small
Desk, Secretary Bed, Youth Sand Box
Fireplace Equipment Chair, Child's Spreader
Foot Stool Chair, High Table
Lamp, Floor Chest, Toy Umbrella
Magazine Rack Dresser Wheel Barrow
Music Cabinet Crib    
Piano, Baby Grand Table, Child's Miscellaneous  
Piano, Parlor Grand Playpen Ash or Trash Can
Radio, Table Rug, Large or Pad Basket (Clothes)
Record Player Rug, Small or Pad Bicycle
Rugs, Large Roll or Pad     Bird Cage & Stand
Rugs, Small Roll or Pad Kitchen   Card Table
Sofa, 2 Cushions Breakfast Chairs Cabinet, Filing
Sofa, 3 Cushions Breakfast Table Carriage, Baby
Sofa, 4 Cushions Chair, High Chairs, Folding
Sofa, Sectional Ironing Board Clothes, Hamper
Hideabed Kitchen Cabinet Cot, Folding
Tables, Occasional Roaster Desk, Office
Tables, Coffee/End Serving Cart Fan
Telephone Stand Stool Plant Stands
TV or Radio Console Table Foot Lockers
TV Table Utility Cabinet Garbage Cans
    Vegetable Bin Golf Bag
Dining Room       Heater
Bench, Harvest Appliances   Incinerator
Buffet Air Conditioner Metal Shelves
Cabinet, Corner Dehumidifier Ping Pong Table
Cabinet, China Dishwasher Pool Table
Chair, Dining Dryer Power Tools
Server Freezer Sled
Table, Dining Ironer Step Ladder
Tea Cart Range Suitcase
Rugs, Large or Pad Refrigerator Table, Utility
Rugs, Small or Pad Vacuum Cleaner Tackle Box
    Washing Machine Tool Chest
Bedroom       Tricycle
(Bed incl. Spring & Mattress)   Porch/Outdoor   Vacuum Cleaner
Bed, Double Barbecue Wagon, Child's
Bed, King Size Bath, Bird Wastebasket
Bed, Single Lawn Chairs Work Bench
Bed, Rollaway Porch Chairs Sewing Machine
Bed, Bunk Clothes Line    
Bookshelves Clothes Dryer Please describe any additional items below:  
Bureau/Dresser Garden Hose and Tools  
Cedar Chest Glider or Settee  
Chair, Boudoir Ladder, Extension  
           


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