OMEGA VAN LINES
 
ABOUT US LOCAL MOVE LONG DISTANCE PACKING STORAGE REFEREMCES
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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



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