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Customer Information
Student's Name*
First Last
Student's Phone Number*
Parent's Phone Number
Student's Email*
Parent's Email
School*
Pickup Address*
Street Address Unit # (if applicable) City ZIP Code
Type of Housing*
Building Name (if applicable)
Requested Pick-Up Date*
MM slash DD slash YYYY

*Please check our "Schedules" page to ensure that you choose an available date.*
Requested Pickup Time Window*
Would you like in-room pickup?*
- Yes, please pick my things up directly from my room ($40).
- No thanks, I will bring my belongings curbside to have them picked up (no additional charge).
*In-room pickup can be added or removed at any time before your pickup date.
Will you be storing any furniture with us? (bed, futon, dresser, couch, desk, etc...)*
- Yes
- No
*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.
Please list furniture items that you plan to store*
Comments/Special Requests
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 Payment Card*
Payment Card Number*
Card Security Code*

3-digit number on back of card. For AMEX, 4-digit number on front.
Card Expiration Date (Month)*
Card Expiration Date (Year)*
Billing Zip/Postal Code*
Terms and Conditions Agreement*
- By clicking here, I agree to the University Student Storage LLC Terms and Conditions

*Having issues submitting your sign-up form? If so, please call us at 602-919-8289 to sign up over the phone!*

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Customer Information

Billing Information