Moving Interstate

Interstate Online Form

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Customer information

Title:

First Name*:

Last Name*:

Email Address*:

Mobile Phone Number*:

Additional information

Yes, I agree to receive occasional updates
and specials from Two Men and a Truck.

Comments / Message*:

* Required Field

1. Customer information

Title
First Name*:		Company Name:
Last Name*:		Mobile Phone Number*:
Email Address*:		Fax:

2. Furniture and Effects Customer Inventory

From (Pick Up information):

Pick Up Address*:
Suburb/Town*:
State*:
Access*:

Telephone:
Home*:
Work*:
Mobile*:
At least one number required*

To (Delivery information):

Delivery Address*:
Suburb/Town*:
State*:
Access*:

Telephone:
Home*:
Work*:
Mobile*:
At least one number required*

3. Estimated Removal Dates / Additional information

Pack Date*:

Uplift Date*:

Delivery Date*:

To ensure that Your removal is planned as smoothly as possible please answer the following questions:

	Details:
What is the best way to contact you?*
How did you hear about us?*
Would you like us to pack your cartons?*
or would you prefer the packing materials supplied? (How many?)*
Do you need storage? (How long for?)*
Will insurance be required?*
Would you like all the cartons professionally unpacked?*
Who is paying for the relocation?*
Is this move confidential?*

Any further information/special requirements

Additional Information*:

Yes, I agree to receive occasional updates
and specials from Two Men and a Truck.

4. Detailed equipment information

Bedroom 1

Basket:	Bed Head:	Bed, Double:
Bed, King:	Bed, Queen:	Bed Single:
Bedside Table:	Chest of drawers large:	Chest of drawers small:
Chest/Glory box:	Dressing Table:	Mirror:
Rug:	Television:	Wardrobe:
Picture carton:	Portarobe carton:	Standard carton:

Bedroom 2

Bed, Bunks:	Bed, Double:	Bed, Queen:
Bed Single:	Bedside Table:	Chair:
Chest of drawers:	Chest:	Desk:
Dressing Table:	Rug:	Toys:
Wardrobe:	Picture carton:	Standard carton:

Bedroom 3

Bed, Bunks:	Bed, Double:	Bed, Queen:
Bed Single:	Bedside Table:	Chair:
Chest of drawers:	Chest:	Change table:
Dressing Table:	Cot:	Dressing Table:
Fan:	Mirror:	Toy box:
Toys:	Wardrobe:	Picture carton:
Standard carton:

Bedroom 4

Bed, Bunks:	Bed, Double:	Bed, Queen:
Bed Single:	Bedside Table:	Chair:
Chest of drawers:	Chest:	Desk:
Dressing Table:	Rug:	Toys:
Wardrobe:	Picture carton:	Standard carton:

Lounge/Family

Air conditioner:	Armchair:	Bean bag:
Bookcase Large:	Bookcase Small:	Bureau:
Card table:	CD stand:	China cabinet:
Cocktail cabinet:	Coffee table:	Couch 2 seat:
Couch 3 seat:	Entertainment unit:	Heater / radiator:
Lounge suite modular:	Mat / rug:	Magazine tidy:
Mirror:	Nest of Tables:	Occasional table:
Organ:	Other chairs:	Paintings:
Piano:	Piano stool:	Pouffe:
Sideboard:	Standard lamp:	Stereo:
Speakers:	Stereo:	Stereo cabinet:
Stool:	Table (Side):	Table (Lamp):
Television cabinet:	Television plasma - lcd:	Television:
Wall unit:	Book carton - lcd:	Picture carton:
Standard Carton:

Hall

Carpet / underfelt:	Glory box:	Grandfather clock:
Hall stand:	Hall table:	Linen press:
Painting:	Pedestal:	Telephone Table:
Picture carton:	Standard carton:

Dining Room

Bookcase Large:	Bookcase Small:	Buffet/sideboard:
Chairs (dining):	Crystal cabinet:	Dresser:
Mat / rug:	Table (dining):	Traymobile:
Picture carton:	Standard carton:

Laundry

Basket:	Brooms etc:	Clothes Horse:
Clothes Dryer:	Cupboard:	Dry cabinet:
Ironing Board:	Linen Basket:	Stool:
Table:	Trolley:	Washing Machine:
Standard carton:

Kitchen

Bar fridge:	Chairs:	Dishwasher:
Freezer:	High Chair:	Refrigerator:
Stool:	Table:	Tidy:
Vegetable tidy:	Microwave:	No. of Cartons:

Sundries

Bar:	Bird bath:	Canoe / Kyak:
Christmas tree:	Corner unit:	Esky:
Excersie bike:	Filing cabinet:	Folding chair:
Folding table:	Golf buggy:	Golf clubs:
Grandfather clock:	Gym equipment:	Heater patio:
Motorbike:	Ottoman:	Plant stand:
Pool table:	Pram:	Rocking Horse:
Swivel Chair:

Outside Effects

Bench:	Bicycle:	Crates:
Chairs:	BBQ:	Child's chair:
Dog kennel:	Dustbin:	Edger:
Esky:	Garden chair:	Garden table:
Garden setting:	Garden tools:	Ladder:
Mower & catcher:	Pot Plants (max 30):	Roof rack:
Roller Garden:	Spa:	Swing set:
Table tennis:	Tool chest:	Toy pram:
Tricycle:	Metal Shelving:	Wheelbarrow:
Workbench:	Trampoline:

5. Send Detailed Form