Estimate form for Domestic Small-scale move system "Single Pack"

* Necessary info.

+ Where to contact
Name*
E-mail*
Phone number
+ Address where you move from
Address
City*
Prefecture*
Zip code
If you live in condominium or apartment, you live in	th floor
The condominium or apartment has an elevator?	Yes No
+ Address where you move to
Address*
City*
Prefecture*
Zip code
Country*
If you move to condominium or apartment, the floor is	th floor
The condominium or apartment has an elevator?	Yes No
Estimated day you move	of
+ What you shipping Please put number for each item which you ship.
+ Electrical appliance
Microwave	sets	TV over 41 inches	sets
Big Fridge	sets	TV up to 40 inches	sets
Medium Fridge	sets	TV up to 30 inches	sets
Small Fridge	sets	TV up to 20 inches	sets
Dish washer	sets	TV up to 14 inches	sets
Coffee percolator	sets	VCR	sets
Hot plate	sets	DVD player	sets
Rice cooker	sets	Desktop computer	sets
Washing machine	sets	Laptop computer	sets
Air cleaner	sets	Printer for computer	sets
Humidifier	sets	Kotatsu	sets
Vacuum cleaner	sets	Component stereo	sets
+ Furniture
Big Wardrobe	sets	King-size bed	sets
Medium Wardrobe	sets	Queen-size bed	sets
Small Wardrobe	sets	Double bed	sets
Big Bookshelf	sets	Single bed	sets
Medium Bookshelf	sets	Sofa bed	sets
Small Bookshelf	sets	Big Cupboard	sets
Sofa for 3 people	sets	Medium Cupboard	sets
Sofa for 2 people	sets	Small Cupboard	sets
Sofa for 1 people	sets	Dining table for 6 people	sets
Dressing table	sets	Dining table for 4 people	sets
Fixed desk	sets	Dining table for 2 people	sets
Sectional desk	sets
+ Items to be boxed How many boxes does it become when you stuff the box with the following items? (Box size is 58 x 38 x 29cm)
Tableware	boxes	Shoes	boxes
Clothes	boxes	Miscellaneous items	boxes
Books	boxes
+ Items not to be boxed
Futon & Blankets	sets	Snowboard	sets
Mattress	sets	Surfboard	sets
Kitchenware	sets	Fishing rod	sets
Bicycle	sets	Guitar	sets
Ski	sets	Keyboard	sets
Golf bag	sets	Piano	sets
+ Please inform us if there is some more items you ship above mentioned

+ Questions & Requests
(For example) I'd like to ship a motorbike with household effects... We hope to ship some of our stuff to Tokyo, the other to Los Angeles..., etc.