Repair Form

Contact Info

Phone

In the Kansas City Metropolitan Area: (816) 333-5300
Outside Kansas City: 1-800-798-5228

Fax

Facsimile: (816) 333-2152

Address

P.O. Box 24570 or 7535 Troost
Kansas City, Missouri 64131-0570

General Email

Sales Information
Rental Information
Website Administrator
Customer Service

All Contact Info >>

Repair Form

Please Note:

All customers will be notified via mail when equipment is ready for pickup

Please direct all questions to This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Customer/Billing Information

Customer/Company Name:
Requested By/Contact Name:
Address:
City:
State:
Zip:
Phone Number:
Fax Number:
Email Address:

Delivery/Pickup Information

Customer/Company Name:
Requested By/Contact Name:
Address:
City:
State:
Zip:
Phone Number:
Fax Number:
Email Address:

Customer Pickup/Return

Pickup Date:
Pickup Time:
For Use:
Customer Return Date:
Customer Return Time:

Delivery/Pickup

Delivery Date:
Delivery Time:
For Use:
Setup Required:
Pickup Date:
Pickup Time:

**Additional Charges for Delivery/Pickup/Setup

Equipment Requirements

Description of Equipment and Accessories/Connections/Quantity Required:

Customer Payment Information

Please specify: MasterCard VISA American Express
Credit Card Number:
Expiration Date:
Full Name On Card:

Shipping

Pickup UPS(red/blue) FedEx Courier
Customer's FedEx Account Number:

Please Contact Me With Exact Rental/Delivery/Technician Setup Charges/More Info: *

* Please specify by phone, fax, Email

Providing audio visual services for over 60 years

Contact Info