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Initial: *
Contact address: *
Postcode: *
E-mail address: *
Home telephone: *
Work telephone: *
Mobile:
How did you hear about us?
When?:
When will the move take place? (approximately) *
Removal from:
Address: *
Postcode: *
Property type *	- please select - House Flat Bungalow Bungalow chalet type
If flat - which floor?
If flat - lift available?	- please select - YesNo
Parking:
Removal to:
Address: *
Postcode: *
Property type *	- please select - House Flat Bungalow Bungalow chalet type
If flat - which floor?
If flat - lift available?	- please select - YesNo
Parking:
Lounge, dining room etc: Article: No of items: Settee, large Settee, large Settee, small Armchair, large Armchair, medium Armchair, small Tub armchair Occasional chair Wicker lounge chair China cabinet, large China cabinet, medium China cabinet, small Welsh dresser Sideboard, large Sideboard medium Sideboard, small Dining table large Dining table medium Dining table small Gate-Leg table, medium Refectory table Occasional table, small Dining chair Carver Roll-Top desk, large Roll-Top desk, small Bureau, large Bureau, small Sectional bookcase, per sec Bookcase, large Bookcase, small Folding card table Grandfather clock Standard lamp Carpet fitted Piano, Grand normal Piano, upright Piano, miniature Piano Player Piano stool Piano stool, duet Radiogram, normal TV table model TV console Music cabinet Hi-Fi Stereo units Corner cupboards Video / DVD Wall units Carpets Rugs Pictures Mirrors Bedrooms: Article: No of items:  Wardrobe, 6’6”  Wardrobe, 4’6”  Wardrobe, 3’0”  Wardrobe, 2’6”  Wardrobe Compactum Dressing Table, 4’6” Dressing Chest, 4’0” Chest of Drawers, Large Chest of Drawers, Medium Chest of Drawers, Small Chest of Drawers, Bow Front Tall Boy, Normal Bedroom Chair Lloyd Loom Chair Tib Arm Chair Bed and Bedding 4’6” Divan Bed 4’0” Bed Chair and Cushions Box Spring Mattress Child’s Folding Cot Pedestal Cupboard Bedside Table Box Ottoman Solid Linen Basket Bunk Beds Carpet 12’9” Cont.Headboard Carpets Rugs Pictures Mirrors Kitchen, hall etc.: Article: No of items: Cooker, Large Refrigerator, Large Refrigerator, Medium Refrigerator, Small Washing Machine Tumble Dryer Vacuum Cleaner Electric Floor Polisher Easiwork Cabinet, Small Kitchen Table, Large Kitchen Table, Medium Kitchen Table, Small Kitchen Chair Baby’s High Chair Tea Trolley Store Cupboard, Medium Deep Freezer Dish Washer Microwave Oven Outside effects: Article: No of items: Garden Roller, Large Garden Roller, Small Lawn Mower, Normal Motor Lawn Mower, Normal Hose and Reel Garden Tools, Per Tool Dustbin, Normal Pair 7 Tread Steps Garden Seat, Normal Bicycle Pram Wheelbarrow Water Butt Garden furniture: Article: No of items: Table Chairs Sun Lounger
Miscellaneous:
Please specify:
Please indicate the quantity of packing cases required: China and Glass (1 carton holds approximately 1 single kitchen cupboard) Books (1 carton holds approximately 3ft of shelf space) Miscellaneous (1 carton holds approximately 1 single medium cupboard ) Food Stores / Drink (1 carton holds approximately 1 single kitchen cupboard) Linen (1 carton holds approximately 1 airing cupboard shelf) Clothing (1 wardrobe carton holds approximately 2ft of hanging space) If you have packed your own boxes please state number:
please confirm packing requirments:	- please select - Full Packing Fragiles only No Packing
Please advise us of any items that require specialist care

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