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CONTACT INFORMATION

Moving FROM

Moving TO

First Name * :
Last Name *:
Email Address *:
Home Phone *:
Work Phone :
Fax :
Best time to contact you * :
Estimated move date * :	mm/dd/yyyy
How did you find our web site ? * :

Address:
APT / Ste / Rm :
City :
State * :
Zip * :
Apt Size :
Elevator :

Address:
APT / Ste / Rm :
City :
State * :
Zip * :
Apt Size :
Elevator :

Items to Move

Lving Room :

	Bookcase
	Chair, straight
	Chair, rocker
	Medium Ent. Center
	Lamps
	Chest, cedar

	Small Sofa/loveseat
	Stereo
	Tables, end
	TV (larger than 30")
	Piano

	Cabinet
	Chair, arm
	Chair, overstuffed
	Large Ent. Center
	Pictures

	Large Sofa
	Tables, coffee
	TV (up to 30")
	VCR
	Rugs

Dining Room :

	Buffet (base)
	Cabinet, corner
	Rug (large)

	Chair
	Pictures

	Hutch (top)
	Rug (small)

	Server
	Dining table

Bedroom :

	Bed, single
	Bed, queen
	Bed, bunk (set 2)
	Chair
	Chest, armoire

	Dresser, single
	Dresser, triple
	Pictures
	TV

	Bed, double
	Bed, king
	Bookshelves(sectional)
	Rug (small)

	Dresser, double
	Night table
	Lamps
	Rug (large)

Nursery :

Bed, youth

Chest, toy

Crib, baby

Table, child's

Appliances :

	Aircond/window.sm
	Dishwasher
	Freezer (16 cf. or more)
	Freezer (10-15 cf.)

	Refrigerator (11cf. or over)
	Washing machine
	Refrigerator (6cf. or less)

	Aircond/window, lg
	Freezer 10 cf or or less
	Refrigerator (6 cf. or more)

	Vacuum cleaner
	Dryer
	Refrigerator (7-10 cf.)

Kitchen :

	Chairs
	Microwave oven

Microwave cart

Breakfast table

Ironing board

Porch & Outdoor :

	BBQ grill, small
	Chairs, aluminum

	Lounge chairs
	Chairs, metal

BBQ grill, large

Table

Misc :

	Bicycle
	Filing cab. 2 door
	Suitcase

	Exercise equipment
	Fine Art
	Trash can

	Desk, office
	Filing cab. 4 door

	Computers
	Musical instruments

Boxes :

Medium boxes

Small boxes

Wardrobe boxes

Large boxes

General Information

Will you need: Packing Unpacking Storage / Estimated number of boxes to be moved:

Items of extraordinary value :

Comments :

42-13 69th Street, Woodside NY 11377, Phone : 212-920-7601