Summit Van Lines for Your Moving & Relocation needs...

Summit Van Lines assures you safe and reliable transport of your belongings. Our movers are specially trained in packing and crating and we are able to offer unsurpassed packing services.

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Contact Information
Full Name:*
E-Mail Address:*
Home Phone:*
Work Phone:	Extension:
Fax:

Estimated move date:

Moving from

Moving to

Address:
City:
State:
Zip Code:
Home Size:
Elevator:	Yes No
If walk up, write # of Floors:

Address:
City:
State:
Zip Code:
Home Size:
Elevator:	Yes No
If walk up, write # of Floors:

Will you need: Packing Unpacking Storage

Item	Qty
Air Conditioner
Armoire
Bed - Bunk
Bed Frame
Bed - Single
Bed - Full/Double
Bed - Queen/King
Bicycle
Book Case
Book Shelf
Buffet Base
Buffet top
Cabinet - Curio
Cabinet - Display
Cabinet - Large
Chair-Child/folding
Chair-Dining
Chair-Living Room
Chair-Office
Chair-overstuffed
Chair-Rocking/arm

Item	Qty
Chest / Trunk
Computer
Desk - Large
Desk - Small
Dresser - Small
Dresser-Medium
Dresser-Large
Ent. Center-small
Ent. Center-med.
Ent. Center-Large
File Cabinet - 2
File Cabinet - 4
Futon
Futon Frame
Ironing Board
Ladder
Lamp
Microwave
Mirror - Picture
Piano - Grand
Piano - Upright

Item	Qty
Rack / Bakers
Refrigerator - Med.
Refrigerator - Large
Rug
Sofa-Regular
Sofa-Large
Sofa- Loveseat
Stereo
Table - Coffee / Sofa
Table - Dining
Table - End / Night
Table - Kitchen
toolbox
TV stand
TV - Small 20"
TV - Medium 29"
TV - Large 36"
TV - Big Screen
Vacuum Cleaner
VCR - Component
Washer/Dryer

Additional Items	Qty

Order Boxes	Qty
Book Box- Small
Linen Box-Medium
China Box-Large
Picture Box
Wardrobe
White Paper

Additional Comments