Furniture Allocation Name First Last Unique ID Client PhoneClient Email(Required) Client Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Case ManagerAngel LozanoBarbara JohnsonBriotony PorterChris CollinsChristina MillerDaylon LopezDebbie JollyDeborah GreenGloria JimenezKenya CollinsLori Red ElkMelvin CollinsYoli SalazarCase Manager Email(Required) Case Manager Phone(Required)Enter Quantities BelowBed FrameBed SpringMattressDresserCloset *Free StandingDesk - ComputerDesk - RegularChair - DeskChair - SofaChair - Living RoomChair - Dining RoomTableCouchRefrigeratorStovePianoCoffee MakerMicrowaveOther - QuantityOther - Description CommentsNameThis field is for validation purposes and should be left unchanged.