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
 
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
878 Viewfield Road, Victoria, BC, V9A 4V1
   
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