houston furniture bank distribution site
Store
Contact Us
About You
Social worker & client information
Social Worker Name
*
First
Last
Agency
*
Social Worker Cell # (for texting)
*
Social Worker eMail
*
Client Name
*
First
Last
Client Ship-To Address
*
Line 1
Line 2
City
State
Zip Code
Country
Client Phone Number
*
Agency's Client Number (if any)
*
Client eMail
*
Pick One (OK to change later)
*
Shop in our Showroom
Web Cart Shopping
Transport (OK to change later)
*
Client truck
Delivery (based on mileage)
Delivery Floor
*
First Floor
Second Floor
Above Second Floor
Above Second Floor with Freight Elevator
Comment
*
Submit