Customer Information Form
Please fill the customer information form below and submit it to be contacted with a quote. Fields marked with a red star are mandatory. Thank you for considering Daniel Movers!
Customer Name
Customer Phone
Customer Email
How Do You Prefer To Be Contacted?
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Email
Phone Call
Text
Preferred Start Time:
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Morning
Afternoon
Loading/Pickup Address
Load Type
Apartment
House
Office
Floor Level/Stories
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1
2
3
4
5
6
7
8
9
10
Unloading/Delivery Address
Unload Type
Apartment
House
Office
Floor Level/Stories
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1
2
3
4
5
6
7
8
9
10
All customer information will be kept with descretion and will not be used for other marketing or advertisment purposes without customer approval.
Desired Date of Move
Do You Need Packing Services?
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Yes
No
Not Sure
Do You Need Boxes or Other Moving Materials?
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Yes
No
Not Sure
Do You Need Storage Services?
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Yes
No
List Items in Living Room:
List Items in Dining Room / Breakfast Room:
List Items in Kitchen:
List Items in Study / Home Office:
List Items in Master Bedroom:
List Items in Other Bedrooms:
List Appliances (washer, dryer, refrigerator):
List Items in Attic / Garage / Patio:
List Large Items such as Pianos or Safes:
List Lamps, Pictures, Art, Mirrors:
List Approximately How Many Boxes:
Special Requests or Instructions:
How Did You Hear About Us?
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Referred
Word Of Mouth
Facebook
Google Search
Previous Customer
Other
SUBMIT THE CUSTOMER INFORMATION FORM