Move Date:
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How did you hear about Great White Moving?
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Preferred method for us to contact you.
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First Name *
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Last Name
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E-mail Address *
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Home Phone
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Work Phone
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Fax:
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Origination Address, City, State
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Destination Address, City, State
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Origination Zip Code
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Destination Zip Code
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| Living Room |
Office |
Sofa
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Office or Roll-Top Desk
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Loveseat
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Desk Extension
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Hide-a-Bed
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Desk Chair
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Chaise Lounger
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Credenza
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Futon
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Two Drawer Filing Cabinet
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Tv stand
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Four Drawer Filing Cabinet
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Organ
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Fire Proof Filing Cabinet
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Entertainment Center
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Conference Table
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Bookcases
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Drafting Table
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Recliners, Arm-Chairs, Rockers
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Copier
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Ottomans or Footstool
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Computer Desk
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Coffee or End-Table
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Hutch
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27" to 36" TV
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Computer Components (# of pcs)
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8" to 26" TV
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Treadmill/Elyptical
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Large screen TV
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Storage Cabinet
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Stereo Components,
Speakers, VCRs
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Lamps or Pictures
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Piano (DOWNSTAIRS)
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Baby Grand Piano
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| Bedroom |
MISCELLANEOUS |
Headboard or Footboard
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Bridge Bed / Wall unit (# pcs)
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King or Queen Size Bed*
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Boxes Less than 50 lbs.
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Full Size Bed
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Boxes More than 50 lbs.
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Twin Size Bed
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Glass Tops
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Bunk Bed
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Glass Shelves
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Water Bed
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Marble Tops
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Day Bed/Trundle Bed
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Area Rugs
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Dresser
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Large Plants
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Mirror (detached)*
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Small Plants
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Chest of Drawers
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Sewing Machines
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Armoire or Wardrobe (empty)
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Bar-B-Que or Bicycle
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Nightstand
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Patio Table
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Cedar Chest or Trunk
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Ironing Board or Vacuum
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Crib and/or Changing Table*
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Patio Chairs
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Linear Feet of Clothes (on rod)
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Lawn Mower
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Small Desk
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Metal Shelf
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Do you need us to dissassemble/reassemble beds or crib?
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Curio Cabinet
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Do you need us to remove mirror from dresser?
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Etagere'
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Hall Tree
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| Dining Room |
KITCHEN |
Dining or Kitchen Table
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Stove or Oven
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Dining Chairs or Bar Stools
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Refridgerator or Freezer*
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China Cabinet (1 or 2 pieces)
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Washer or Dryer
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Buffet or Server
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Microwave
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Microwave Stand
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Do you need us to disassemble or hook-up appliances?
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Please mention anything not listed above:
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Would you consider the majority of your furniture to be :
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Elevator at either location?
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How many flights of stairs at "origin"?
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How many flights of stairs at "destination"?
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Walk in excess of 100' at either location? List each over 100'
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"Sloped path" at either location? Please describe.
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Approximate number of miles from one point to next
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