Contact Information *Your Name :  *Email Address :  *Phone Number (Home) :  Phone Number (Work) :  Mobile Number :  - Relocating From - Address :  Suburb/Town :  State :  Postcode :  Tick Applicable :  Narrow Stairs Internal Stairs External Stairs Narrow Street Narrow Driveway Steep Driveway Unit/Apartment/Flat? :  - Select One - Yes No If yes, What Floor? :  Does it have a lift? :  - Select One - Yes No - Delivery To - Address :  Suburb/Town :  State :  Postcode :  Tick Applicable :  Narrow Stairs Internal Stairs External Stairs Narrow Street Narrow Driveway Steep Driveway Unit/Apartment/Flat? :  - Select One - Yes No If yes, What Floor? :  Does it have a lift? :  - Select One - Yes No Extra Information Moving Date :  - Select One - I've entered the dates below Immediate Move Within 30 days Within 90 days Don't know just yet Pickup Date :  - Day - 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th 21st 22nd 23rd 24th 25th 26th 27th 28th 29th 30th 31st - Month - January February March April May June July August September October November December - Year - 2006 2007 2008 2009 Delivery Date :  - Day - 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th 13th 14th 15th 16th 17th 18th 19th 20th 21st 22nd 23rd 24th 25th 26th 27th 28th 29th 30th 31st - Month - January February March April May June July August September October November December - Year - 2006 2007 2008 2009 Packing Service Required? :  - Select One - Cal Van Lines to pack ALL cartons Cal Van Lines to pack SOME cartons only I will pack ALL cartons Storage Service Required? :  - Select One - Yes No Packing Cartons :  Qty Standard Carton Qty Book Carton Qty Picture Pack Qty Clothes Pack Qty Portarobe Additional Services Required :  Unpacking Car Cleaning Special Instructions :  Inventory - Lounge Rooms/Living Rooms Sofa (2 Seat) Sofa (3 Seat) Chairs (Arm) Chairs (Recliner) Chairs (Other) Bean Bag Grandfather Clock Piano/Organ Musical Instruments Tables (Occasional) Tables (Coffee) Tables (Other) China Cabinet Bookcase (Large) Bookcase (Small) Shelving Filing Cabinet Entertainment Unit TV Cabinet Video Player Television Stereo Stereo Speakers CD/Wine Rack Bar Fridge Fish Tank Bird Cage Lamp Picture/Painting Rug Heater Air Conditioner Fan Inventory - Dining Area Dining Table Dining Chairs Side Board China Cabinet Buffet & Hutch Picture/Painting Rug Inventory - Kitchen/Laundry Table Chairs/Stools Child's High Chair Electric Appliances Microwave Oven Dishwasher Refrigerator Freezer (Upright) Freezer (Chest) Washing Machine Clothes Dryer Sewing Machine Laundry Trolley Clothes Horse Ironing Board Vacuum Cleaner Brooms etc Bins/Tidy/Baskets Inventory - Bedrooms Bed (Single) Bed (Double) Bed (Queen/King) Bed (Water) Bed (Bunk Bed) Bed (Crib) Bassinette/Stand Toy Box Table (Dressing) Table (Changing) Table (Other) Bedside Cabinet Tall Boy Wardrobe Chest Of Drawers Camphor Chest Bookcase (Large) Bookcase (Small) Desk Chair Lamp Mirror Picture/Painting Rug Television Air Conditioner Heater Fan Suitcase Inventory - Office/Study Computer Printer Scanner Fax Machine Desk Chair Bookcase (Small) Bookcase (Large) Shelves Filing Cabinet Picture/Painting Bins/Baskets Inventory - Sports/Excercise Bike (Kids) Bike (Adult) Bike (Excercise) Pool/Snooker Table Table Tennis Golf Bag/Buggy Swing Set Trampoline Camping Gear Surf Board Canoe Inventory - Garage/Outside Pram/Stroller Esky BBQ Dog Kennel Bird Bath Table (Garden) Table (Other) Chairs (Garden) Chairs (Folding) Bench Workbench Lawn Mower Whipper Snipper Garden Tools Hoses Shelving Wheelbarrow Ladder Antenna Compost Bin Inventory - Special Requirements/Extra Inventory Please list below any special requirements you think may be important to your inventory. If there are other items you have not listed in the above form, please type them below with quantities. Information Accuracy The above information is as accurate and correct as I can provide, however additions and deletions may occur later. Please provide me with a quotation based on the above information. I understand that your estimator will be required to assess my goods. How did you hear about Caloundra Van Lines? : - Select One - Google (Search Engine) Moved with us before Ninemsn (Search Engine) Referred by a Company Referred by a Friend Yahoo (Search Engine) Yellow Pages (Book) Yellow Pages (Online) Other Other :
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