Pre Rental Order Form at iloveradios.com I Love Radios.com : I Love Radios.com

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Pre-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
Company Name *
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
Event Name
Date Equipment is to Arrive*
Date Equipment to be Shipped Back *
Rental Start Date *
Rental End Date *
Delivery Method *
Radio Information:
Portable Radios	Qty
	VHF UHF No Preference

Mobiles	Qty
	VHF UHF No Preference

Intrinsically safe rentals	Yes No

Base Stations	Qty

Repeaters	Qty

Disposable Earpiece	Qty

Surveillance Kit	Qty

Remote Spkr Mic	Qty

Light Duty Headsets	Qty

Med Duty Headsets	Qty

Heavy Duty Headsets	Qty

Spare Batteries	Qty
Notes if any special programming needed
Do you need us to provide you an On-Site Support Staff?	Yes No

Promotional Code If any


How did you hear about us?
Association Name (if any)

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