Manufactured Home Transport/ Tear Down / Set Up Services Questionnaire

PNW Used Mobile Homes d/b/a PNW Referral Services maintains a Directory of licensed, bonded and insured transportation, tear down and set up service providers in Washington, Oregon and Idaho.  Our Directory is provided to manufactured home buyers and others free of charge.  To ensure buyers receive complete information we also request copies of licenses, bonds and insurance binder/declaration pages from service providers and keep those on file with yearly updates.    

We are always looking to enhance our Directory and we invite you to provide your company information by completing this Questionnaire.  Submitting the Questionnaire starts the review process for consideration to be added to the Directory and does not mean you are entering into an agreement with PNW Used Mobile Homes.  

After you submit the Questionnaire, a member of our team will review your responses and if the information you submitted meets the criteria we are looking for, you will be contacted to discuss your responses.  We look forward to receiving your information.
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Email *
Business Name *
Name of Owner *
Name of primary contact? *
Street Address, City, ST Zip Code *
Phone Number(s).  
Use this format please:  (123) 456-7890
 *
Can you receive texts at this number? *
PNW Referral Services works with licensed and bonded service providers.  Please select below whether you are licensed and bonded.   *
Required
By checking the box below (required), I agree to email a copy of my license and bond immediately after submitting this Questionnaire. *
Required
If you are not licensed and bonded, please explain why.
What state(s) are you licensed to work in?  Please select all that apply. *
Required
Which counties (listed by state) do you prefer NOT to work in? *
What type of service(s) do you provide and/or prefer?  Please select all that apply. *
Required
How do you prefer to receive new referrals? *
Required
If your business is on social media, please enter the link to your business.  If not, please enter "N/A".  *
If your business has a website, please enter the link.  If not, please enter "N/A". *
Please let us know a little more about your business and services.   *
How did you hear about us? *
Required
CONTACT VERIFICATION
By selecting today's date from the calendar below, you agree to allow PNW Referral Services to contact you via email, phone or text.  

You may opt out of receiving future notifications by notifying us at info@pnwumh.com.

Thank you for your time.
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A copy of your responses will be emailed to the address you provided.
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