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*Your Name:  *Your e-mail address:
*Phone Number:  Cell Number: 
How did you hear about us?    Date of Move:
Pick-Up Address
Address 1:
Address 2:
City, State Zip Code: 		Delivery Address
Address 1:
Address 2:
City, State Zip Code:
Are there stairs at either location (more than 5 steps)?
 yes    no  		Any Assembly or Disassembly required?
yes  no
Do you require boxes moved?  yes    no  Sm boxes to be moved:    Lg boxes to be moved:

Piano Moving - Please Choose  
Quantity:              Value:  $

If Grand Piano over 6 feet,
please call (843) 906-4951
Item Quantity Value (approx)   Item Quantity Value (approx)   Item Quantity Value (approx)
Bed   Sewing Machine   Entertainment Center
Mattress   Dining Table   Desk
Crib - Day bed   Kitchen Table   Computer
Bunk Bed   Chair   File Cabinet
Dresser   Credenza   Stands
Mirror   China Cabinet   Microwave
Chest   End-Coffee Table   Stereo -  Electronics
Armoire   Sleeper   Speakers
Nite Stand   Sofa-Love Seat   TV
Cedar Chest   Recliner-Rocker   Plants
Lamps   Ottoman   Refrigerator
Wardrobe   Ironing Board   Freezer
Bookcase   Clothing   Vacuum
Tool Boxes   Attic Goods   Wall Unit
Exercise Equipment   Buffet   Washer
Lawn Equipment           Dryer

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