Your Email Address

Destination Location Consignee

Name

First Name

Last Name

Destination Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Consignee Phone

(###)

###

####

Pickup Address of Sender

Sender Name

Sender Address

Sender Phone

(###)

###

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Shipment Details

Pickup Date

YYYY

Lift Gate Required

Residential Area

Number of Pallets

Class

Pallet Dimensions

Standard pallet is 42x44

Weight

(put in brackets estimated weight of pinball is 320lbs with skid,1 skid)

Hold for pick up at terminal near you*

Home delivery required (add +USD$150 for US or + CAD$150 for CA)