Quote

Please fill out this form then print and fax or 'click' the submit button on the bottom to send by email

* = Required Fields

Personal Details
First Name *
Last Name *
Email *
Work Phone
Home Phone
Fax
Mobile

Contact Type
How would you like to be contacted? : * Phone
  Fax
  Email

Pickup Address
Unit No.  
Floor No. Select any that apply:
Street No. * Steep Driveway
Address * We are in a unit or flat
Suburb/Town * The units/flats have a lift
State * Narrow Driveway
Postcode Narrow Street

Delivery Address
Delivery: * I require Caloundra Removals & Storage to store
my furniture and effects for weeks
  Deliver to (full address to be advised)
  Deliver to the following address

Unit No.  
Floor No. Select any that apply:
Street No. Steep Driveway
Address We are in a unit or flat
Suburb/Town * The units/flats have a lift
State * Narrow Driveway
Postcode Narrow Street

Relocation Details
Pickup Date * (dd/mm/yyyy)
Delivery Date (dd/mm/yyyy)
Storage Required for weeks

Bedroom 1 Items
Item Qty Item Qty

Bedroom 2 Items
Item Qty Item Qty

Bedroom 3 Items
Item Qty Item Qty

Bedroom 4 Items
Item Qty Item Qty

Dining Room Items
Item Qty Item Qty

Lounge Room Items
Item Qty Item Qty

Kitchen Items
Item Qty Item Qty

Laundry Items
Item Qty Item Qty

Study Items
Item Qty Item Qty

Outside Items
Item Qty Item Qty
   

Sundry Items
Item Qty Item Qty

Hall Items
Item Qty Item Qty

Family Room Items
Item Qty Item Qty
   

Relocation of other items or Other relocation services.
This may include Pets, Motor Vehicles, Boat Transport or any service requirement

Special Instruction or Comments
If you have any concerns please list them here so we can ensure your instructions are carried out during your relocation

Professional Packing Services
Do you require Caloundra Removals to carry out professional packing services on your behalf?
Full pack | Fragile pack only | No Packing
Should you select professional packing services we will provide a per carton price to supply and professionally pack including all materials.

Insurance Confirmation
My calculated household insurance value: $
I require full cover insurance Yes | No
I require restricted cover insurance Yes | No
I require in store insurance Yes | No
I have read and understand the Product Disclosure StatementAdobe Acrobat PDF Document Yes | No
I have read and understand the Financial Services GuideAdobe Acrobat PDF Document Yes | No
I have read and understand the Policy Wording Adobe Acrobat PDF Document Yes | No

Where did you find us?
Recommendation
Used Caloundra Removals before
Yellow Pages Book
             Which Book?
Yellow Pages Online
Search Engine (ie Google)
Saw Vehicle
Other
If other, describe