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Campus: University of Rochester
Dorm: all dorms
Date Time: to be determined --- to be determined

Name
Email Address
Your Phone
Your Cell Phone
Parent/Guardian Name
Parent/Guardian Phone
Dorm Name/Building
Room Number

Note:
Please Remember, the prices indicated on this form INCLUDES the pickup, delivery and the storage of your possessions... If you're unsure what each container may hold, please visit our Container Sizes page.

Qty:		Please Select Container Size 10 Cu. Ft. ::: ( 40Lx19Wx24 ) ::: Dish Carton ::: ( 18Lx18Wx28H ) 3.1 Cu. Ft. ::: ( 18Lx18Wx16H ) 1.5 Cu. Ft. ::: ( 16Lx12Wx12H ) Mini Fridge ::: ( Sizes may vary ) Misc Storage ::: ( per Cu. Ft. ) Futons ::: ( per each )
Qty:		Please Select Container Size 10 Cu. Ft. ::: ( 40Lx19Wx24 ) ::: Dish Carton ::: ( 18Lx18Wx28H ) 3.1 Cu. Ft. ::: ( 18Lx18Wx16H ) 1.5 Cu. Ft. ::: ( 16Lx12Wx12H ) Mini Fridge ::: ( Sizes may vary ) Misc Storage ::: ( per Cu. Ft. ) Futons ::: ( per each )
Qty:		Please Select Container Size 10 Cu. Ft. ::: ( 40Lx19Wx24 ) ::: Dish Carton ::: ( 18Lx18Wx28H ) 3.1 Cu. Ft. ::: ( 18Lx18Wx16H ) 1.5 Cu. Ft. ::: ( 16Lx12Wx12H ) Mini Fridge ::: ( Sizes may vary ) Misc Storage ::: ( per Cu. Ft. ) Futons ::: ( per each )
Please indicate any additional storage needs below, and someone from our office will contact you with any additional details and pricing. Thank You! Additonal Items