Help-U-Move | Contract | Request for Moving Services

HELP-U-MOVE CONTRACT REQUEST FORM
Request for moving services
Please print this form and fill in the information necessary. Please note, this form is for mailing and faxing only, it can not be e-mailed.
After you have received a written price quote, please fill out and fax or mail the following to us a long with the $75 deposit:
Mail to: Help-U-Move 85 Commercial Way, East Providence, RI 02914
OR
Fax to: (401) 434-5178

Please write or type the address you are moving from (origin):

Name:
Address
City, State and Zip
Phone Number - Home
Pager or cellular
Phone Number - Work
Fax Number Required for us to fax you the contract
Email Address
SPOT DATE requested drop off day	Weekday's only (We only drop off &r pickup trailers on weekdays)
PICKUP DATE requested day we pickup goods	Weekday's only (We only drop off & pickup trailers on weekdays)

Please write or type the address you are moving to (destination):

Address
City, State and Zip
Phone Number
Alternate Contact Number
Space Quoted
Price Quoted

Deposit information: A deposit of $75 is required when reserving a truck. The deposit is non refundable and will be subtracted from the final cost of the move. The deposit can be made with a major credit card or by mailing a check to the above address.
Credit Card
Cardholders Name:
Card Number:
Expiration Date:
Cardholder Signature:
We accept American Express, Discover, VISA & MasterCard
Make checks payable to: Commercial Sales & Marketing or CSM