Become A Service Provider
If you are a Service Provider and you provide the services we offer on our website to our customers. We
invite you to fill out the information form below so we can add you in our database and when our
customers come to us for moving help we can send them to you and all customers are to pay you at the
completion of the job in cash or desired payment method you accept .
COMPANY NAME *
COMPANY ADDRESS *
CITY/STATE/ZIP *
COMPANY PHONE NUMBER *
ALT CONTACT NUMBER (CELL/PAGER)
FAX NUMBER
CONTACT PERSON *
E-mail Address: *
HOURS OF OPERATION *
PLEASE SELECT THE SERVICES YOU OFFER *
Loading Help
Unloading Help
Packing of Boxes Help
Unpacking Of Boxes Help
Furniture Assembly/DisAssembly
Rental Truck Driving Service
Transloading Load Swap
PLEASE SELECT EACH TEAM PACKAGES YOU OFFER (CAN SELECT MORE THAN ONE) *
ONE MAN TEAM
2 MAN TEAMS
3 MAN TEAMS
4 MAN TEAMS
5 MAN TEAMS
DO YOU PROVIDE MOVING TRUCKS *
YES
NO
IF YOU PROVIDE TRUCKS PLEASE PROVIDE DOT#
IF YOU PROVIDE TRUCKS PLEASE PROVIDE MCC #
HOW FAR DO YOU TRAVEL FROM OFFICE ZIPCODE *
HOW DO YOU ACCEPT PAYMENT FROM CUSTOMERS *
CASH
VISA/MASTERCARD
DISCOVER CARD
AMERICIAN EXPRESS
PERSONAL CHECK
MONEY ORDER OR CERTIFIED BANK CHECK
COST FOR 2 MAN TEAM PER HR
COST FOR 2 MAN TRAVEL CHARGE
COST FOR 3 MAN TEAM PER HR
COST FOR 3 MAN TRAVEL CHARGE
COST FOR 4 MAN TEAM PER HR
COST FOR 4 MAN TRAVEL CHARGE
COST FOR A 5 MAN TEAM PER HR
COST FOR A 5 MAN TRAVEL CHARGE
* Required