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Name *

Phone number *

Email *

Moving date (if known)

Moving from (address) *

Floors (Number of floors your items will be carried up/down by movers) *Ground floor1 Floors2 Floors3 Floors4 Floors5 +

Moving to (address) *

Floors (Number of floors you items will be carried up/down by movers)Ground floor1 floors2 floors3 floors4 floors5+

How many bedrooms are you planning on moving? *

• 1 Room
• 2 Rooms
• 3 Rooms
• 4 Rooms

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