Quickly Obtain a Free Estimate Via Fax
Simply print out the form below and complete all necessary information then fax to:
860-635-7234 - Attn: Pam

First Name
____________________________________________________________________

Last Name
____________________________________________________________________

Phone Number
____________________________________________________________________

Fax Number
____________________________________________________________________




1. Where are you moving to and from, include the town & state?
   To: ________________________________________________________________
   From: ______________________________________________________________
   
   
2. Are there any Elevators and/or Flights of Stairs at either location? (Circle One)
   Yes   No
   
   
3. Can a 53-foot truck park within 75 feet of your front door? (Circle One)
   Yes   No
   
   
4. Let us know about any large items such as, pianos, hot tubs, etc.
   ____________________________________________________________________
   
   
5. When do you want to move?
   ____________________________________________________________________
   
   
6. Would you like us to pack? (Circle One)
   Yes   No
   
   
7. How many rooms of furniture are you moving? _________
   For a more accurate estimate, provide us with a detailed list of items -
   don't forget to include the number of boxes.
   ____________________________________________________________________
   ____________________________________________________________________
   ____________________________________________________________________
   ____________________________________________________________________
   ____________________________________________________________________
   ____________________________________________________________________
   ____________________________________________________________________
   
   
8. Many companies have transportation agreements with northAmerican Van Lines,
   let us know who will be paying for your relocation.
   ____________________________________________________________________
   
   
9. Need a car quote? (Circle One)
   Yes   No
   Include the year, make and model.
   ____________________________________________________________________
   
   
10. Would you like a realtor to contact you? (Circle One)
    Yes   No
    

FYI - Payment Terms:

1. Upon Delivery: Cash, Certified Check, Money Order, or Travelers Checks
2. Major Credit Cards are accepted. A simple authorization form must be completed prior to loading. The corporate office manages this process, not the driver.
3. If your company is paying for the move, tell us. We will assist you with the necessary paperwork to set up a direct billing.