Southern Winds International

Contact Information
Name:
Email:
Phone (Home):
Phone (Work):
Fax:

Moving From
Address:
City:
Country:
State:
Zip / Post Code:
Number of flights of stairs:

Moving To
Address:
City:
Country:
State:
Zip / Post Code:
Number of flights of stairs:

Approximate date of move :

Will the residence at your
destination be ready by the
time of the move?

Yes No

Temporary storage
space required?

Yes No

To be paid by:

Employer Self

Name of employer
(if employer-paid move):

Service type:

Transportation Mode:

If Alternative Move Service,
please specify :

Auto(s) :

Yes No

Year :

Make / Model :

Currently living in :

Please tell us how large your home is by indicating how many of each of these room types have. If you have any of these types of rooms, but nothing needs to be moved from that type, enter 0 or leave the box blank.

Please fill in all that apply:	↑ Bedrooms ↑
↑ Bathrooms ↑	↑ Family Room ↑
↑ Dining Room ↑	↑ Basement ↑
↑ Kitchen ↑	↑ Attic ↑
↑ Storage Shed ↑	↑ Living Room ↑
↑ Garage ↑	↑ Sun Room / Enclosed Porch ↑

Estimated Weight (if survey has been provided):
Estimated Volume (if survey has been provided):

Use our Calculator - Estimated value only

Click here

Number of Major Appliances:

Have you previously moved
with us?

Yes No

Comments: