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Name
*
Name
Name
Name
Phone
*
Email
*
Preferred appointment date
*
REMOVAL FROM
*
Post Code
*
House, Flat, Storage?
*
House
Flat
Storage
Number of Bedrooms
*
Studio
1
2
3
4
5
6
7
8
9
10
10+
Floor
*
0
1
2
3
4
5
5+
Is There a Lift
*
Yes
No
Parking Restrictions
*
None
Residents Permit
Single Yellow Line
Double Yellow Lines
Red Route
REMOVAL TO
*
Post Code
*
House, Flat, Storage?
*
House
Flat
Storage
Number of Bedrooms
*
Studio
1
2
3
4
5
6
7
8
9
10
10+
Floor
*
0
1
2
3
4
5
5+
Is There a Lift
*
Yes
No
Parking Restrictions
*
None
Residents Permit
Single Yellow Line
Double Yellow Lines
Red Route
LIVING/DINING ROOM
*
Yes
No
2 Seater Sofa
0
1
2
3
4
5
6
7
8
9
10
10+
3 Seater Sofa
0
1
2
3
4
5
6
7
8
9
10
10+
4 Seater Sofa
0
1
2
3
4
5
6
7
8
9
10
10+
Armchair
0
1
2
3
4
5
6
7
8
9
10
10+
Cabinet
0
1
2
3
4
5
6
7
8
9
10
10+
Chest Drawers
0
1
2
3
4
5
6
7
8
9
10
10+
Bookcase Large/Normal
0
1
2
3
4
5
6
7
8
9
10
10+
TV Large/Normal
0
1
2
3
4
5
6
7
8
9
10
10+
Mirror
0
1
2
3
4
5
6
7
8
9
10
10+
Tv Stand
0
1
2
3
4
5
6
7
8
9
10
10+
Foot Stool
0
1
2
3
4
5
6
7
8
9
10
10+
Glass Cabinet
0
1
2
3
4
5
6
7
8
9
10
10+
BEDROOMS
*
Yes
No
Double Kingsize Bed
0
1
2
3
4
5
6
7
8
9
10
10+
Mattress
0
1
2
3
4
5
6
7
8
9
10
10+
Single Bed
0
1
2
3
4
5
6
7
8
9
10
10+
Baby Cot
0
1
2
3
4
5
6
7
8
9
10
10+
Bunk Bed
0
1
2
3
4
5
6
7
8
9
10
10+
Rocking Chair
0
1
2
3
4
5
6
7
8
9
10
10+
Chest Drawers
0
1
2
3
4
5
6
7
8
9
10
10+
Wardobe Large/Normal
0
1
2
3
4
5
6
7
8
9
10
10+
Bedside Table
0
1
2
3
4
5
6
7
8
9
10
10+
Dressin Table
0
1
2
3
4
5
6
7
8
9
10
10+
Dresser
0
1
2
3
4
5
6
7
8
9
10
10+
Rug
0
1
2
3
4
5
6
7
8
9
10
10+
APPLIANCES
*
Yes
No
Cooker
0
1
2
3
4
5
6
7
8
9
10
10+
American Fridge
0
1
2
3
4
5
6
7
8
9
10
10+
Washing Machine
0
1
2
3
4
5
6
7
8
9
10
10+
Dishwashwer
0
1
2
3
4
5
6
7
8
9
10
10+
Fridge Freezer
0
1
2
3
4
5
6
7
8
9
10
10+
Microwave
0
1
2
3
4
5
6
7
8
9
10
10+
Tumble Dryer
0
1
2
3
4
5
6
7
8
9
10
10+
Coffe Machine
0
1
2
3
4
5
6
7
8
9
10
10+
STUDY / OFFICE
*
Yes
No
Desk + Chair
0
1
2
3
4
5
6
7
8
9
10
10+
Filling Cabinet
0
1
2
3
4
5
6
7
8
9
10
10+
Desktop Computer
0
1
2
3
4
5
6
7
8
9
10
10+
Printer / Copier
0
1
2
3
4
5
6
7
8
9
10
10+
GARDEN AND OTHERS
*
Yes
No
BBQ
0
1
2
3
4
5
6
7
8
9
10
10+
Garden Table + Chairs
0
1
2
3
4
5
6
7
8
9
10
10+
Plants
0
1
2
3
4
5
6
7
8
9
10
10+
Chilren Slide / Swing
0
1
2
3
4
5
6
7
8
9
10
10+
Shed
0
1
2
3
4
5
6
7
8
9
10
10+
Lader
0
1
2
3
4
5
6
7
8
9
10
10+
Garden Tools
0
1
2
3
4
5
6
7
8
9
10
10+
Paresol / Umbrella
0
1
2
3
4
5
6
7
8
9
10
10+
Notes
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