Tallahassee Courier Inc Customer Request Form
(FOR COLLECTIONS ONLY)
Requester
*
First Name
Last Name
Company Name
Email
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Requester's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Delivery Date
*
-
Month
-
Day
Year
Date
Job Delivery Speed
Urgent Delivery (within an hour or less) $25 Rush Fee will apply
Express Delivery (within 1-3 hours)
Same Day Delivery (within 3-6 hours)
Next Day Delivery (usually in the A.M.)
Other
Collection Contact Person
*
First Name
Last Name
Phone Number
Please enter a valid phone number.
Collection Company Name
Collection Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Quantity 1 2 3
*
Number of Items
Description of collection item(s) and/or detailed instructions on where to go for pickup services.
*
Help us save time by being as detailed as possible.
Submit
Should be Empty: