name *

First Name

Last Name

phone *

(###)

###

####

the fridge has been hosed/cleaned inside and out *

Yes

the fridge will be plugged in AT LEAST 2 days before pickup *

Yes

What condition is the fridge in? *

Like new

working, but not new

working, some parts missing

does your fridge have any of the following ?

ice maker

water hookup

would you be able to transport the fridge? *

yes

no

if no, best pick up time? *

Hour

Minute

Second

AM PM

if no, what day of the week is best for pick up?

Mon

Tues

Wed

Thurs

Fri

Sat

Sun

if no, what would be the latest pick-up date?

MM

DD

YYYY