MH Home Order Form 2.1

MerryHands Home Order Sheet

Order a Home Service in Minutes!
Who is filling out form?*
Starting City*
When do you need service?*
First Name of Who We Help*
We have availability...Call in to get an actual Job Date & Time!!

***We detected that some of the things you requested require you to call in to see when we can get you a job date and time***
For a Last Minute/Same Day Service... Call For Availability!

***You will have to call to get confirmed after you submit. It normally takes us up to 2 hours after a submission is received to get guys last minute. The number of guys subject to availability***
Service Type:*

PackingAssemblyCleanout-Move In/Move OutPicture & Curtain HangingOther Handy Job
Move Type:*

LoadUnload
How big is the place?*
How many rooms?*
Please pick closest size
How many Items?*
Please pick closest size
Please list the items: *
How many Pictures?*
Please pick closest size
How many windows/curtains?*
Please describe the job:*
How Many Movers?*
How Many Hours?*
**Minimum Hours for 1 Man is 3 Hours**
How Many Hours?*
**Minimum Hours for 2 Men is 2 Hours**
How Many Hours?*
**Minimum Hours for 3 Men is 3 Hours**
How Many Hours?*
**Minimum Hours for 4 Men is 4 Hours**
Do you need Truck?*
Size of Truck Needed?*
How many miles? ($1 per mile)
Add-Ons Included in Price:

DisassemblyAssemblyPacking (Up to 2 hrs)
Add-Ons for Additional $:

Basic Coverage-$14.99Waste Disposal-$40Basic TV Mount-($25 each TV)Standard Coverage- $29.99
Add-Ons for Additional $:

2 Hours of PackingBasic Coverage-$14.99Standard Coverage- $29.99
How Many TVs Mounted? (4 Limit)*
Man Hour
2 Man Hour
3 Man Hour
4 Man Hour
Estimated Amount of Hours
1 Man Labor Miminum:
2 Men Labor Miminum:
3 Men Labor Miminum:
4 Men Labor Miminum:
Labor Total:
Truck & Transport Total:
Add-On Total:
Job Estimated Total:
Job Estimated Total:
Job Estimated Total:
Job Estimated Total:
Starting Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
For Starting Location

Add apt#Add Bld#Add Gate CodeAdd Unit #Other Address Info
Starting Apt#
Starting Bld #
Starting Gate Code #
Starting Unit#
Add Middle Location
Middle Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
For Middle Location

Add apt#Add Bld#Add Gate CodeAdd Unit #Other Address Info
Middle Apt#
Middle Gate Code #
Middle Bld #
Middle Unit#
Ending Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Ending Address Not sure yet/TBD
For Ending Location

Add apt#Add Bld#Add Gate CodeAdd Unit #Other Address Info
Ending Apt#
Ending Bld #
Ending Gate Code #
Ending Unit#
Job Date #1*
Time of Day Preferred?*
Enter the Time of Day you'd like to Move..**This will not be confirmed yet until we can confirm through call or text**
Requested Job Date #1*

MonthDayYear
**This will not be confirmed yet until we can confirm through call or text**
Time they requested?

Hour Minutes

AM/PM Option
Will some of this job be done on different date?
Job Date #2 (If Applicable)

MonthDayYear
Date
Primary/Person Moving*

PrefixFirst NameMiddle NameLast NameSuffix
Customer Phone#*
Please enter a valid phone number.
Add email later or not sending to customer
Contact Email Address*
example@example.com
Is this email the same as billing email?*

YesNo
Billing Email Address*
example@example.com
Alternative Contact/Representative #
Please enter a valid phone number.
Alternative Contact

First NameLast Name
Alternative Contact*

First NameLast Name
Alternative Email Address
example@example.com
Alternative Email Address*
example@example.com
How did you hear of us?*

Word of MouthGoogleCraigslistRepeat CustomerSocial Media: Facebook/InstagramSocial Media: OtherFrom one of our staff
Have you used us before?*

Yes, I'm a repeat customerNo, I'm a new customerI am selling something
Please verify that you are human*
Should be Empty:

MerryHands Home Order Sheet

We have availability...Call in to get an actual Job Date & Time!!

For a Last Minute/Same Day Service... Call For Availability!