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Online Request Form

Customer Name:   Phone # HM  
Address From: WK
  E-mail
Address To: Approx. Date:
 
  Approx. Miles:
Flights of Stairs:  
Long Walks (over 75'):
Current: Current:
New: New:
 
Current: Current:
New: New:

           
Living Room
QTY.
Bedroom
QTY.
Other
QTY.
Entertainment Center
Armoire
Bicycles
Bookcases
Bed, King/Queen/Day
Kids Toys
Wall Unit/Pieces
Bed, Full/Twin
Misc. Exercise
TV-Stand
Bed, Water
Glass Tops
Chairs, Occasional
Chest of Drawers
Pictures
Ottoman
Mirror, Standing/Wall
Lamps
Piano/Upright
Dresser
Plants/Large
Piano/Grand
Lingerie Chest
Patio Furniture
Sofa
Night Stand
Lawn Mower
Loveseat
   
BBQ Grill
Hide-A-Bed
Kitchen/Utility
 
Trunk Or Chest
Sectional Sofa/Pieces
Microwave Cart
Boxes-Under 50 lbs
Coffee/Sofa Table
Microwave
Boxes-Over 50 lbs
TV-Portable/Under 25"
Ironing Board
Boxes-Wardrobe
TV-Console
Refrigerator/Freezer
   
Stereo Components
Vacuum Cleaner
Miscellaneous
 
Stereo Speakers
Washer(Disconn.)
Stereo Cabinet
Dryer(Disconn.)
   
Office
 
Dining Room
 
Computer
Buffet, Sideboard
Office Chairs
China Cabinet
Credenza
Dining Chair/Stools
Desk, Office or Rolltop
Dining-Breakfast Table
Desk, Secretary
   
File Cabinet
   
Printer/Fax

 TIME IS IMPORTANT! Please call me ASAP!

 

 

 

3401 Corder St. Houston, Texas 77021
Phone: 713-748-6024

Fax    : 713-748-1780.

 

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