Please complete the following information fields so that we can service your needs as soon as possible.
We will contact you within 24 hours after you submit this form. We appreciate you choosing CampusStorage as your moving and storage provider. Thanks so much for your time and we look forward to meeting you!

Required Fields (*)

First Name:*
Last Name:*
Phone Number:*
Alternate Phone Number:
Email:*
Verify Email:*

School:*	Select USC New York University Columbia University Loyola Marymount University UCLA Point Loma Stanford University of Arizona SDSU University of San Diego UCSD
Yes No Priority Scheduling – We will get you a convenient pick up and drop off time even if you are late to schedule one. One hour pick up and delivery time window instead of two. Insurance is included on all your items in storage for the duration of time stored. Guarantee of pick up within your time slot, if not, get an instant 5% off your order. 10% off your order for next years' services! All of these great benefits for only $19.99/per month
Pick Up Date:*	/ / (mm/dd/yyyy) Pick Date From Calendar
Pick Up Time:*	8am-9am 9am-10am 10am-11am 11am-12pm 12pm-1pm 1pm-2pm 2pm-3pm 3pm-4pm 4pm-5pm 5pm-6pm The Campus Storage moving team will arrive sometime between the one, or two hour time window that you have selected depending on the service package you have chosen.

Dorm:
Room #:
Please note: Address locations over 5 miles from campus are subject to additional fee.
Off Campus Housing Address:
Off Campus Housing Apartment/Unit #:
Off Campus Building Name: (If applicable)
Off Campus Housing City:
Off Campus Housing State:
Off Campus Housing Zip Code:

Please note all storage terms are a three month minimum.

Service:*

Summer Storage Study Abroad Stoarge Shipping

Insurance can be added for $1 per $100 of insurance coverage.

No Insurance $1 for $100 of Insurance Coverage $2 for $200 of Insurance Coverage $3 for $300 of Insurance Coverage $4 for $400 of Insurance Coverage $5 for $500 of Insurance Coverage $6 for $600 of Insurance Coverage $7 for $700 of Insurance Coverage $8 for $800 of Insurance Coverage $9 for $900 of Insurance Coverage $10 for $1000 of Insurance Coverage $11 for $1100 of Insurance Coverage $12 for $1200 of Insurance Coverage

Boxes & packing materials will be delivered to you approximately 1 to 2 weeks before your pick up date. You will not be charged for returned/unused packing supplies. Boxes & Packing Materials
	Number of MEDIUM sized boxes (17x17x17 inches)
	Number of LARGE sized boxes (17x17x34 inches)
	Rolls of packing tape (1 roll covers about 3 boxes)
	Quantity of packing bubbles (approximately 2' x 5')
Mattress Bag(s) King:    Queen:     Full:
Miscellaneous Items (These are items you will not being putting in a box)
	Approximate number of X-SMALL miscellaneous items (example: poster, frames, etc.)
	Approximate number of SMALL miscellaneous items (example: fan, lamp, printer, etc.)
	Approximate number of MEDIUM miscellaneous items (example: mini fridge, chair, etc.)
	Approximate number of LARGE miscellaneous items (example: television, table, bicycle, etc.)
	Approximate number of X-LARGE miscellaneous item (example: large couch, bed, etc.)

First Name:
Last Name:
Relationship:
Phone Number:
Alternate Phone Number:
Email:

How did you hear about us:
Referred By: (if applicable)	First Name: Last Name:
Promotion Code: (if applicable)
Terms & Conditions:*	Yes, I agree to the Terms & Conditions