Nextel Order Form Order your Nextel radio here at I Love Radios.com : I Love Radios.com

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Nextel - Rental Order Form

Please complete This form and one of our rental consultants will contact you within 24 hours. For immediate quotes please call us directly at 1-800-822-6677 Monday through Friday 9am-6pm EST.

(* Required Field)

Contact Information
Account Name *
Referred by
Contact Person *
Phone *
Fax
E-mail *
Address *
City*
State *
Zip Code *
What is the best way for us to contact you?	Phone E-mail Mail
Billing Information (if different from above )
Name
Address
City
State
Zip Code
Shipping Information (if different from the billing address )
Name
Address
City
State
Zip Code
Equipment
Rental Event Name
Date Equipment is to Arrive*
Date Equipment to be Shipped Back *
Rental Start Date *
Rental End Date *
Is this an open ended rental? *	Yes No
Delivery Method *
Equipment Requirements :
# of Nextels	(holster and rapid charger included)

Will you provide name list for programming?	Yes No

Do you need Group Call?	Yes No I Don't Know (a customer representative will call to discuss)

Direct Connect (walkie-talkie) use ONLY?	Yes No, I need cellular usage as well

Do you need international call capability?	Yes No

Accessory Requirements (write in quantities):
Earpieces	Qty

Car Chargers	Qty

Spare Batteries	Qty

Desktop Chargers	Qty

Other
Is your event taking place indoors or outdoors?	Indoor Outdoor

If indoors, please provide a brief description of the venue (name, how many floors you need to cover, structure type-convention center, hotel, concrete, etc.)

Do you need us to provide you an On-Site Support Staff?	Yes No
If yes, what dates? *If you don’t know, we will contact you to discuss

Please let us know other if there is any Equipment or Accessories not listed that you also want a quote for: