Online Piano Rental Company Quotation Form
Online Musical Instrument Rental Company Quotation Form


Please fill in ALL the blanks
(Secured by SSL)
Name            
Title          
Your Full Name          
             
Your eMail required - lower case letters only          
             
Your Phone  
Your Fax
   

Piano(s) (State Grand or Upright, Make, Model (size) or other descriptive details).
Musical Instrument (s) & Back-line required


Delivery Details
     
Date of Delivery    
Time of Delivery (Time is flexible - or not flexible)
Date of Pick-Up    
Time of Pick-Up (Time is flexible - or not flexible)
Stage Height    
Leesee Has On Site Crew to Assist Pro Piano? ( Yes No)

Numbers of Flights, Stairs, Steps
Elevator? ( Yes No)
If Yes, Floor Dimensions of elevator?
and/or
description of difficult moving contingencies

Delivery Location  
Facility or Hall Name
Street Address
City, State & Zip Code
Contact Person Onsite
Onsite Phone Number
Billing Details  
Cardholder's Company Name
Cardholder's Name in Full
Cardholder's Street Address
Cardholder's City, State & ZIP Code
Cardholder's Phone
Cardholder's Fax
Cardholder's eMail
Credit Card Details (Not Mandatory, but no quotation is a firm reservation without credit card details)
Visa, Master Card, American Express, JCB
Card Number Expiration Date (mm/yy)
Security ID from back of card      

Pro Piano will respond with a quotation in less than 24 hours,
or you will be given a 15% discount on the total order

Pro Piano reserves the right to raise said quotation if you have
inadvertently withheld critical information that impacts the overall price

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