Customer Information

Pickup Scheduling Form

Customer Information

Please enter the following information and click on the "Submit" button to schedule your pickup. You will receive an email message confirming the schedule date. As a cost consideration, we request that you schedule your pickup on a date that our truck will be in your neighborhood.

To schedule pickup of FURNITURE or 10 boxes/bags or more, you must call (404) 761-6247 to schedule your pickup. Also, if you have questions about a pickup date, please call this number.

Items in RED are required to complete your request.

1. Did you receive a FLYER in the Mail?

2. If "YES", Enter the Pickup Date found on the Flyer.
Example: mm/dd/yy

3. Which organization is this pickup for (who is the dated card from)?

YOUR INFORMATION:
4. Customer Name: (Last Name, First Name)

5.  Address:
(If applicable)            House/Apt.                                                                                                                                       (If applicable)
Hwy/Route            Number           Street Name (ONLY)                                                     Suffix                 Quadrant

Example:101                 5289                       Lakeview                                                                                                    Dr                        NE
City                                                                                  State                                     ZIP

Home Phone: Number only, please. No spaces, parentheses, commas or hyphens

Cross Streets Example: Main Drag Rd and My Place St.

6. Customer Comments:

Email Address: (necessary for email confirmation)

7. Pickup Information:
Approximate number of Bags or Boxes:

Pickup Spot:

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