A. van Leeuwenhoeksweg 50, 2408 AN Alphen aan den Rijn
     
+31 (0)172-449977
    
info@khz.nl
A. van Leeuwenhoeksweg 50, 2408 AN Alphen aan den Rijn   
C

    Your personal information

    Last name*

    E-mail address

    Order number*

    Your personal travel information

    Personal ORIGIN departure date

    Personal ARRIVAL at destination date

    From which date can you be reached at destination?

    Destination Hotel name (if applicable)

    Destination Hotel phone number (if applicable)


    Destination residence

    Below, please fill out your (new) full destination address:*

    Is new residence available immediately after arrival?
    yesno

    Can your goods be delivered at first possibility after arrival (and customs clearance if applicable)?
    yesno

    Do you require (temporary) storage of your goods at destination?
    yesno

    Your emergency phone number that you have access to while travelling

    Your emergency e-mail address that you have access to while travelling

    Address information

    Type of residence

    If type of residence is Other, which type?

    If type of residence is Apartment, which floor?

    If type of residence is Terraced or Detached, amount of floors?

    Leave blank if not applicable

    Are we allowed to use the internal elevator?
    yesno

    Can all the items fit the internal elevator?
    yesno

    Is an external elevator (moving lift) POSSIBLE?
    yesno

    Is an external elevator (moving lift) NECESSARY?
    yesno

    *E.g. certain items cannot be brought into the residence without the use of an external elevator

    Parking at destination address

    Can we park at a maximum 20 meter walking distance from residence/apartment building entrance with large truck/container (18 mtrs)?
    yesno

    Distance from first available parking spot to residence/apartment building entrance? ± … mtrs

    Do you have a possibility to keep parking spots available for our truck/van/container?
    yesno

    Is a parking permit advisable or NECESSARY*?
    yesno

    Mandatory in certain cities!

    Is paid parking applicable?
    yesno

    Is it a dead-end street?
    yesno

    Any other circumstances we need to take into account?*

    Additional information

    When you use this form, you agree to the storage and processing of your data through this website.



    *=required field(s)