Order Form

| | | | | |

Order Form

Please select from the options below to tailor the order to youe exact requirements. If the option is not in your requirements please leave blank.

First name:
Last name:
Email address:
Company / House No
Address 1:
Address 2:
City:
County:
post code:
Phone:
Please enter address you would like the delivery /collection to be from if different from the above
What date would you like your goods delivered?
What time do you want your goods delivered?
What is the order number / quote ref for your goods?
Who are the goods coming from?(vendor / store name)
what date will the items arrive with us?
Brief Description of goods
Please select if you want us to accept and deliver your goods
Please select if you require items taken away and disposed of
Brief Description of goods
Please select if you would like us to redeliver your old items to an another address (in local area)
Brief Description of goods
Please enter the other address
Please specify if you would like us to hold your goods in our warehouse
Please select if you require disposal of any packaging
please tick to say that you have read our terms and conditions
Home-4U can have good links with local traders who can assist you in the installation of specific items. If you would like us to contact a local tradesman on your behalf to get them to contact you and quote please select from the following services

Home-4u, c/o Impala Logistics Ltd, Office 17, Evans Business Centre,

Dane Street, Rochdale. OL12 6XB

Company number 6077030 registered in England.

Sitemap