Dorm2Dorm - College Summer Storage - We're here from Start to Finish

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Please complete the following form to sign-up for our appliance/furniture rental center. Double check your contact information is 100% correct to ensure our best customer service possible. We look forward to serving your needs, if you have questions regarding your order at anytime please email us at info@dorm2dorm.com.


	Contact Information

	Name
	Phone Number
	Email Address

	Pick Your School
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	How did you hear about us?
	Enter discounted promotion (if applicable)
	Referred By


	Address

	ON CAMPUS					OFF CAMPUS
	Dorm					Address
	Building					Apartment #
	Room #					City
						State
						Zip

Dates

Please list the most convenient drop-off time for your products. You should be receiving a phone call as soon as we process your order in order to finalize and confirm your date along with answer any questions you might have.

Month

Day

Time


	Alternate Contact Information
	Please list a parent or guardian's contact information if for some reason we can't get a hold of you. (i.e. billing, contact information, emergency, etc.)

	Name
	Phone Number
	Email Address
	Address
	City
	State
	Zip

Items

Please select the quantity of each item you would like to rent.

		Sanyo Refrigerator Space saving mini-fridge great for any dorm or apartment		QTY
		Emerson Microwave Stylish, sleek, and extremely affordable		QTY
		Black Futon Space saving design doubles as a couch and a bed		QTY
		Office Chair Finally, a comfortable place to study in your own dorm or apartment		QTY
		Panasonic 42" Plasma Television You're now the talk of the floor with this gadget		QTY
		Panasonic 27" Flat Tube Television Economical, affordable, and sleek		QTY
		Sony Progressive Scan DVD Player The best picture quality available		QTY
		Philips - 5.1-Ch. Home Theater System/DVD/CD/MP3/DivX Player Turn your dorm or apartment into a move theater		QTY
		Nintendo Wii - with 4 controllers One of the most advanced video game consoles ever		QTY
		Microsoft - Xbox 360 Console System - with 4 controllers Fun is calling, pick-up and answer		QTY
		Sony - PlayStation 3 System - with 4 controllers Enjoy the weekend, unwind a bit		QTY

You will receive a phone call in order to finalize your order & confirm an exact delivery time. By clicking you are agreeing to the terms and conditions as listed on the website - (view terms & conditions).