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Enquiry - Domestic Removals

Highlighted fields are mandatory    
Customer Name Email
Mobile Number    
Alternate Contact Number Fax Number
Referred by ( Name )        Referred by Email
Referred by Contact Number    
Relocation Type Personal Relocation Commercial Relocation  
Basic services provided for a domestic relocation ( tick as appropriate )
Dismantle Pack Load to
Unload from
Unpack Assemble    
Do you require Temporary Storage Yes    No    
Do you require cargo insurance for the relocation ? Yes    No    
Additional services we could provide if required by customers ( tick as appropriate )
Curtains Remove Refit
Permanent Electrical Fittings Remove Refit
Carpets Remove Refit
Audio / Video Connections Remove Refit
  Painting Furniture Repairs
  Plumbing Polishing
  Relocate Pets Relocate Pianos
Other services you want us to do for you
Movement Details From To
Area / Locality
Road / Street Name
Building Name
House Number
No. of Living / Dining Rooms
No. of Bedrooms / Other Rooms
No. of Kitchens
No. of Store Rooms / Garages
Does the building have a lift ? Yes   No Yes   No
Do you want us to visit your premises for a free pre-quotation survey? Yes No
Preferred dates and times for work Date Time(hr) Time(min)
Survey to be done select
Work to start select
Work to Complete select
How would you like to pay ?  
Would you like us to deliver empty boxes & masking tape to help you prepare in advance? Yes     No
How many boxes are needed
Item List / Other Details (Cut & Paste or Type)
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