Atlantis Forwarding Ltd - B.H.C Shipping Application Form

B.H.C Shipping Application Form
Your Details:
B.H.C Reference Number
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Home Phone

Area Code Phone Number
Mobile Phone

Area Code Phone Number
E-mail
Destination Details:
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number

Area Code Phone Number
Phone Number

Area Code Phone Number
Consignment Details:
Number of Pieces
Approximate Volume (Cbm)
Collection Date

Day Month Year
Preferred Time

AM PM
Your Allowance:
Please tick as applicable

1.3 Cubic Meters 2.6 Cubic Meters 5.2 Cubic Meters
Insurance:
Insurance: We strongly advise that you take out insurance in the unfortunate event that damage or loss occurs in transit. (please complete below if you require insurance)

Cover1:Fully comprehensive insurance at 4.0% of the value for items packed by ourselves.
Cover2:Fully comprehensive excluding breakage/damage at 3.0% for items packed by yourselves.
Cover1

Cover1 Cover2 NoCover
Total Value (£ GBP)
Enter the message as it's shown *
Should be Empty: