Service / Loan form

Please complete, check your details and authorise. We will confirm your booking by email or phone. Terms and Conditions

Telephone 04 473 1353 for any enquiries.  * indicates required field

Company:
Postal
Address:
Contact: *
Phone:
Fax:
Email: *
Order ref:
Delivery Address: 
Pickup Address:

  Items you wish to enquire about:
 Data - Video Projector  Computer / Laptop
   Video Conference System  Electronic Whiteboard
   Video/DVD Player  LCD Screen
  Projection Screen Microphone(s)
  Audio Speaker System Service Required
Other: 
(please specify)

Required on:

Pick-up on:
Comment:

Any pricing quoted excludes GST and the borrower will be responsible for all loss or damage to any equipment whilst in your care. Communication Partners cannot accept responsibility for non-delivery of equipment when this form has not been authorised, submitted and confirmed. Cancellations not reported in reasonable time could incur a pickup/drop off fee.

Payment:   Cheque   Credit Card
    Account Client   Cash
Authorised by: *  
Designation:  
Date:  

 

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