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Request for Info

Please fill out this form, and we will get back to you as soon as possible

Safe Family Moves


Name *
City, State Moving From *
E-mail address
Phone w/area code (daytime) *
Phone w/area code (evening) *
Moving Dates *
Type of Move
Moving Information *
Please tell us where are you moving to:
State *
Zip *
Current Rooms *
How many rooms do yo have now (not including bathrooms)
Current Sq. Ft. *
What is the square footage of your current home or aparment?
Do you require Packing Service? *
Yes   
No   
Comments
Enter the name of the representative you spoke with or any additional comments in the space provided below:
Appliances
 Air Conditioner Window   
 Dryer Electric Gas   
 Dishwasher   
 Electric or Gas Range   
 Freezer (capacity 10 cu or less)   
 Freezer (capacity 16 cu and over)   
 Fridge capacity<10 cu ft   
 Ironing Board   
 Washing Machine   
 Freezer (capacity 11 to15 cu)   
 Fridge capacity 16 cu   
 Fridge capacity<11-15 cu   
 Vacuum Cleaner   
Dining Room
 Buffet   
 Cabinet Corner   
 Dining Table (6 person or less)   
 Harvest Bench   
 Rug Small or Pad   
 Cabinet China   
 Chair(s) Dining   
 Dining Table (8 person or more)   
 Rug Large or Pad   
 Tea Cart   
Bedroom
 Armoire     Double Bed   
 Bed Bunk (set of 2     King/Queen   
 Bed Rollaway     Cedar Chest   
 Chaise lounge     Futon w/matress   
 Sectional Bookshelves     TV Console   
 Vanity     Wardrobe, Cabinet SM   
 Bed Single or Hollywood     Chair Straight or Rocker   
 Dresser single or chest of drawers     Night Table   
 Triple Dresser     TV Portable   
 Wardrobe, Cabinet LG   
Living Room
 Bar Portable     Bookshelves Sectional   
 Chair Arm     Chair Overstuffed   
 Chair Straight     Desk Large Secretary   
 Entertainment Center Lg     Fireplace Equip.   
 Loveseat     Piano Baby Grand/Upright   
 Rug or Pad Lrg     Small Organ   
 Sofa Rattan/Wicker     Bench   
 Cabinet Curio     Chair Occasional   
 Chair Rocker     Clock Grandfather   
 Desk Sm/winthrop     Entertainment Center sm   
 Floor Lamp(s)     Magazine Rack   
 Piano Spinet/Console     Rug or Pad Sm   
 Sofa (4 cushions)     Sofa( 3 cushions)   
Nursery
 Baby Crib   
 Chair(s) Child   
 Chest   
 Play Pen   
 Toy Chest   
 Bed(s) Youth   
 Chair(s) High   
 Dresser   
 Table(s) Child   
Kitchen
 Bakers Rack   
 Chair(s) Breakfast   
 Serving Cart   
 Table Breakfast   
 Cabinet Utility   
 Microwave Oven/ Roaster   
 Stool(s)   
 Table Utility   
Miscellaneous
 Baby Carriage     Birdcage w/Stand   
 Cabinet Two Drawer Filing     Childs Wagon   
 Desk Office     Foot Locker   
 Golf Bag     Power Tool(s)   
 Shelve(s) Metal     Step Ladder   
 Table Card     Table Pool   
 Tool Chest     Waste Paper Basket(s)   
 Bicycle     Cabinet Five Drawer Filing   
 Chair Folding     Clothes Hamper   
 Fernery or Plant Stand     Garbage Can(s)   
 Plastic Tub(s)     Sewing Machine   
 Standing Fan(s)     Suitcase(s)   
 Table Ping Pong     Table Utility   
 Tricycle     Work Bench   
Boxes and Crates
 1.5 cu Ft Carton   
 4.5 cu Carton   
 Dish Pack/Barrels   
 Wardrobe   
 3 cu Ft Carton   
 6 cu Ft Carton   
 Mirror   
Porch/Outdoor
 Barbeque Portable     Bird Bath   
 Chair(s) Porch     Ladder Extension   
 Lawn Tools( Rakes,etc)     Lawnmower Power   
 Outdoor Gym     Outdoor Swing   
 Rug Large     Sandbox   
 Table Picnic     Wheelborough   
 Bench Picnic     Chair(s) Lawn   
 Garden Hose/Tools     Ladder Step   
 Lawnmower Hand     Lawnmower Riding   
 Outdoor Slide     Rocker Swing   
 Rug Small     Spreader   
 Umbrella(5)   

* Required to submit this form





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