Order Locker

Fields in RED are mandatory ! | Use TAB to move to next field.
1
Personal Information
First Name Last Name Birth Date Email
         
Cell Phone Home Phone Work Phone Why Storing?
 
How did you hear about us?
2
Mailing Address
Suite / Apt # Street # Street Name Country
   
Province / State City Postal / Zip Code
     
3
Emergency Contact
First Name Last Name Suite / Apt # Street #
     
Street Name Country Province / State City
     
Postal / Zip Code Cell Phone Home Phone Work Phone
 
4
Delivery Address
I would like to
have my locker delivered at
load my locker at the U-PAK Warehouse
Same as mailing address
Suite / Apt # Street # Street Name Country
   
Province / State City Postal / Zip Code
     
5
How many lockers would you like?
I would like whole locker(s) and medium locker(s) half locker(s)
Whole Locker Charge / month Minimum one month rental
Half Locker Charge / month Minimum one month rental
Medium Locker Charge / month Minimum one month rental
6
Delivery Information
Deliver On Preferred Time of Day Assured Delivery by Locker Location
     
Parking Stall # Delivery Instruction
 
7
Pick up Information
Pick up On Same Day Pick up Assured Pick up by Preferred Time of Day
Empty locker will return to Storage
   
7
Pick up Information
Return to WH Date Select Return to WH Time
   
8
Payment Information
Payment Mode Credit Card Type Expiration Date
       
Credit Card # Last 4 digits of Credit Card # on record
 
Debit/Credit cards are not an accepted method of payment at this time
Name as appears on Credit Card
First Name Middle Initial Last Name
   
Address where statement sent Same as mailing address
Suite / Apt # Street # Street Name Country
     
Province / State City Postal / Zip Code
         
Please enter the 3- or 4- digit code that appears on the front or back of your credit card

 
9
Insurance Information
Do you want Insurance ? YesNo
Start Date Insurance Amount Warehouse Address
1500 Derwent Way, Delta, BC, V3M 6N7
   
Please note that Insurance is only covered while your contents are inside U-PAK Mobile Storage facility.
10
Pricing Information ( Amount in CAD $ )
Monthly Storage
Pro-Rate Storage
Delivery
Assured Delivery
Same day Pick up
Insurance
Packing Material
PST Tax @ 7%
GST Tax @ 5%
Total Price
CAD
Yes, I have read Customer Declaration