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Urban Order Form
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Name
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Lease Information
Lease Term
*
12-Month
9-Month
6-Month
Urban 12-Month
Price:
Urban 9-Month
Price:
Urban 6-Month
Price:
Additional Items
Please select additional items wanted.
Bed with Frame (Twin) - $88
Bed with Frame (Queen) - $101
Nightstand - $25
Dresser - $47
Desk - $28
Desk Chair - $23
Gaming Chair - $25
Sofa - $57
Loveseat - $46
Sitting Chair - $36
Kitchen Table - $28
Kitchen Chairs - $15
Coffee Table - $19
End Table - $19
TV Stand - $30
Floor Lamp options for bedroom - $30
Table Lamp options for bedroom - $13
Floor Lamp options for Living area - $30
Table Lamp options for living area - $13
Extra Bedroom Set - $99
Bed with Frame (Twin) - $88
Price:
Bed with Frame (Queen) - $101
Price:
Nightstand - $25
Price:
Dresser - $47
Price:
Desk - $28
Price:
Desk Chair - $23
Price:
Gaming Chair - $25
Price:
Sofa - $57
Price:
Loveseat - $46
Price:
Sitting Chair - $36
Price:
Kitchen Table - $28
Price:
Kitchen Chairs - $15
Price:
Coffee Table - $19
Price:
End Table - $19
Price:
TV Stand - $30
Price:
Floor Lamp options for bedroom - $30
Price:
Table Lamp options for bedroom - $13
Price:
Floor Lamp options for Living area - $30
Price:
Table Lamp options for living area - $13
Price:
Extra Bedroom Set - $99
Price:
Please select additional items wanted.
Bed with Frame (Twin) - $71
Bed with Frame (Queen) - $82
Nightstand - $20
Dresser - $38
Desk - $22
Desk Chair - $19
Gaming Chair - $20
Sofa - $46
Loveseat - $37
Sitting Chair - $29
Kitchen Table - $28
Kitchen Chairs - $12
Coffee Table - $17
End Table - $15
TV Stand - $24
Floor Lamp options for bedroom - $24
Table Lamp options for bedroom - $11
Floor Lamp options for Living area - $24
Table Lamp options for living area - $11
Extra Bedroom Set - $99
Bed with Frame (Twin) - $71
Price:
Bed with Frame (Queen) - $82
Price:
Nightstand - $20
Price:
Dresser - $38
Price:
Desk - $22
Price:
Desk Chair - $19
Price:
Gaming Chair - $20
Price:
Sofa - $46
Price:
Loveseat - $37
Price:
Sitting Chair - $29
Price:
Kitchen Table - $28
Price:
Kitchen Chairs - $12
Price:
Coffee Table - $17
Price:
End Table - $15
Price:
TV Stand - $24
Price:
Floor Lamp options for bedroom - $24
Price:
Table Lamp options for bedroom - $11
Price:
Floor Lamp options for Living area - $24
Price:
Table Lamp options for living area - $11
Price:
Extra Bedroom Set - $99
Price:
Resident Information
Resident Name
First
Last
Delivery Date
*
MM slash DD slash YYYY
Apartment Community Name
*
Delivery Address
*
Apartment Number
City
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District of Columbia
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Louisiana
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Maryland
Massachusetts
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New York
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North Dakota
Northern Mariana Islands
Ohio
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Rhode Island
South Carolina
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Tennessee
Texas
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U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Notes
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District
Total
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