Booking form - TECH FOR RENT

Point of Contact*

First Last

Company name

Phone*

Email*

Equipment Required*

Quantity*

Would you prefer Individual or Multi USB Charger (For Ipad)

Delivery Required*

Start Date*

Delivery/Pickup Time (12 hour format AM/PM)*

:

End date*

Collection/Return Time (12 hour format AM/PM)*

:

Mode Of Payment*

Will you be at the site to receive the items?*

Point of contact on site*

First Name Last Name

Phone no of person on Site*

Same Delivery And Collection Address*

Delivery to Address*

Building Name/ Address Level/ Unit/ Name Of Room Postal code

Collection Address*

Building Name / Address Level/ Unit/ Name Of Room Postal code

Additional instructions

Email

This field is for validation purposes and should be left unchanged.