Basic Removal Enquiry Form

How did you hear about Capital Moves?	Please select Yellow Pages Yell.com Helpiammoving UK - Removal Reallymoving Google Truck Friend Email Other
Other:
Full Name:
Company:
Telephone:
Fax:
E-mail Address:
Date of move:	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2008 2009 2010
Address:
Postcode:
Type of property:	House Bungalow Flat Maisonette
Floor Level?	Basement Ground 1st 2nd 3rd 4th 5th 6th Other
Lifts	Yes No
Number of bedrooms:
Parking facilities - details:
Address:
Postcode:
Type of property:	House Bungalow Flat Maisonette
Floor Level?	Basement Ground 1st 2nd 3rd 4th 5th 6th Other
Lifts?	Yes No
Number of bedrooms:
Parking facilities - details:

Please provide details of items that may not be listed above e.g safe or items that may require special attention.

Second pick-up? (if so please give details e.g. post code, floor, lift etc)
Second delivery? (If so please give details e.g. post code, floor, lift etc)
Will you require storage?	Please select Full contents Partial contents Not requested
Do you need packing services?	Please select Full packing Partial packing Not requested
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