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      COURIER SHIPPING RESERVATION FORM

      Required fields are in bold

      Your Name

      Your Phone #

      Your Email

      PICKUP INFORMATION
      Pickup Date

      Pickup Time

      How Many Pieces?

      Total Weight(lbs)

      Business Name

      Contact Name

      Contact Phone #

      Address 1

      Address 2

      City

      State

      Zipcode

      Type of building

      Special Instruction about your pickup

      DROPOFF INFORMATION
      Business Name

      Contact Name

      Contact Phone #

      Address 1

      Address 2

      City

      State

      Zipcode

      Type of building

      Special Instruction about your dropoff

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