Pick-Up Request Company Full Name * Mobile Number * Email Address * Item Name * What are you sending? Number of items * Total Item Weight (kg) * Enter figures only Item Description * Describe what are you sending? Pick-Up date * Delivery date * When do you want the receiver to get the item? Pick-Up City, State * Enter City and State Pick-Up Address * Delivery City, State * Enter City and State Delivery Address * Comments/Note/Remarks