Schroeder Moving Systems, Inc. - United Van Lines Agent

Welcome UW System Employees and State of Wisconsin employees!
Please use this form to receive additional information regarding your move
or to initiate the move process. We are pleased to be of service to you!

Name:

Current Address:

City, State:

Zip Code:

Moving To:

(Zip) (Dept)

Campus:

School:

Dept.:

Home Phone:

Work Phone:

Fax:

Cell Phone:

Pager:

E-mail Address:

Best time to contact:

Number of members in your family:

Current Residence:
Single Family
Apartment or Condo
Have you ever moved
professionally before?
Yes No
If Yes, with whom:

Tentative dates for your move:

Auto:
Yes No

Extra Stop:
Yes No

Lab:
Yes No

Most important concern regarding your move:

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©1998 Schroeder Moving Systems, Inc.
Schroeder is an authorized agent for United Van Lines

I.C.C. No. MC-67234 US DOT #077949

Appleton, WI
2720 East Winslow Ave.
(920) 739-5533
(800) 242-3577

Milwaukee, WI
15700 West Lincoln Ave.
(262) 784-1717
(800) 950-1717