Pyrmont Cares Furniture Request Form (Agency use only)
If you have any questions please contact ops@pyrmontcares.org.au and we will get back to you shortly.

• We deliver on Wednesday between 9:00am-12:00pm to homes in the municipality of City of Sydney suburbs and some adjoining parts of the Inner West Council area.
• We aim to fill requests in the order received and provide what items we have in stock at that time.
• We will deliver to the ground floor or to a floor with lift access. PCI takes no responsibility for the condition, safety, or operability of any furniture or whitegoods. PCI’s liability is limited to the exchange of an item.
• Refurbished mattresses and bed bases are delivered at cost, invoiced to the Agency for payment before delivery.
• By submitting this form, the Support Worker and their Client accept the conditions of service above.
Organisation Name *
Your answer
Organisation Address *
Your answer
Organisation Suburb and Postcode *
Your answer
Support Worker Name *
Your answer
Support Worker Email Address *
Your answer
Support Worker Office Phone
Your answer
Support Worker Mobile Phone
Your answer
Client Name *
Your answer
Has the client recently moved in and is badly in need of furniture?
Client Street Address *
Your answer
Client's suburb *
Suburbs not listed here are outside our delivery area
For the next item, note that if the client has no phone, the case worker must be present for the delivery.
If the client has both home phone and mobile, a response like '9876 5432 or 0432 123 456' is OK
Client Phone (or 'None') *
Your answer
Client Email
Your answer
Lounge items
If more than 1 of an item required, please use Other field to describe number needed
Dining room items
Please indicate number of chairs required in the Other field. If chairs are requested but no number is indicated then 2, 4 or 6 chairs will be supplied to go with a small, medium or large dining table.
Bedroom items
If necessary, please use the Other field to indicate how many of an item are needed. Mattresses and bed bases will be invoiced, and must be paid for before delivery.
Mattresses and Bed Bases must be paid for before delivery. If you are ordering these items you must provide the email address to which the invoice will be sent in the field below.
Email address to which invoices for mattresses and bed bases should be sent (if applicable)
Your answer
Small kitchen items
Limited availability items
Lift and Stairs *
Please note that Pyrmont Cares volunteers are not permitted to carry goods up stairs, which for this purpose we consider to be a set of of more than four steps.
Notes
Information on street parking, loading bay access, narrow doorway into dwelling, limited space for fridge, any special delivery instructions or any other relevant information. For loading bay access, please note that the height of our truck is 3.1 metres.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy