Collection address:

...

Address Line 1 (building/street name)*: 
 

Address Line 2 (apartment / door no.)*:
 

Address Line 3 (city)*:
 

Address Line 4 (postal code)*:

Stairs or lift? :

(if stairs,  how many floors?) :

Return postal code (if known): 

How many boxes:

How many additional items :

Description (i.e. 1 suitcase 75*45*35cm):
Start Date (pick-up / collection date):

Duration (number of weeks):
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Additional Info (any useful info for the collection team):  
Referral / Promo code (if applicable):