Name * First Name Last Name Phone Number * (###) ### #### Email Address * Pickup Address * City * State * Zip Code * Drop-off Address Preferred pickup/delivery date * MM DD YYYY Preferred pickup/delivery time * Hour Minute Second AM PM Notes * I agree to the Terms & Agreement I need assembly or setup included Disclaimer: Delivery begins only after payment is confirmed and approved. We do not shop or pay for items on behalf of clients. Payment Note: Payment for our services is due in full prior to dispatch. We accept Cash App, Zelle, or card. Thank you! Your submission has been received.