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Customer Information

Student's Name*

First Last

Student's Phone Number*

Parent's Phone Number*

Student's Email Address*

*Please use a personal email address. Do not use your school email address. Be sure to check your spam folder if you do not see our email in your inbox after 24 hours.

Parent's Email Address*

School*

Pick-Up Address*

Street Address Address Line 2 City State ZIP Code

Type of Housing*

Building / Dorm Name*

Requested Pick-Up Date

Requested Pick-Up Time Window

*IMPORTANT* You must be packed & ready to have your things picked up at the BEGINNING of your time window. If you are unsure of your pickup time, please leave this section blank for now.

Would You Like In-Room Pick-Up?*

Yes, please pick my things up directly from my room. ($70 fee)
No thanks, I'll bring my items curbside for pick-up. (No additional fee)

Will you be storing any furniture with us? (bed, dresser, desk, futon, couch, etc.)*

*If you are only storing boxes and similarly sized items (dorm fridge, plastic drawer sets, etc...), please choose "no", as those are not considered furniture items.

Yes
No

Additional Comments / Special Instructions

*If you are storing furniture with us, please list those items here.

Billing Information

*You will be charged a $25 deposit at the time of signup to hold your spot. The remainder will be charged after your belongings are picked up. Deposits are fully refundable if order is canceled before you receive your packing supplies.

Name on Card*

Credit Card Number*

Credit Card Security Code (3-digit number on back of card. 4-digit on front for AMEX)*

Expiration Month*

Expiration Year*

Billing Zip Code*

By clicking “Submit”, you agree to the Music City Student Storage, LLC Terms and Conditions.