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Freight Shipment Request Form

Who is the shipment requested by?
Contact Name*
First Last
Phone*
Email*
Company*
Who is this shipping to?
Contact Name*
First Last
Company*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Where is this product shipping from?
Contact Name*
First Last
Phone*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Who does this product belong to?*
Shipment Details
When will this be ready for pickup? DATE*
MM slash DD slash YYYY
TIME*

: HH

MM

AM/PM

Pickup from 8AM to 4PM
Do any of the following apply to this shipment?
- Residential Address
- Liftgate Needed
- Limited Access Pickup
- Inside Pickup
Disclaimer: If any of these selections are required but not selected, up charges will be applied upon delivery.
What are you shipping?
Product Type Number of pallets Total Weight
Special Instructions or Notes

QUESTIONS?

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Sales: 207-610-7748

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165 Pleasant Ave,
South Portland, ME 04106

159 Cash Street
South Portland, ME 04106

10 Ferry Street, Suite 101
Concord, NH 03301