Name*
First Last
How Would You Like Us to Contact You?*
(Select All that Apply)
- Home Phone
- Cell Phone
- Work Phone
- Email
- Mail
Home Phone
Cell Phone
Would You Accept Text Messages?
- Yes
- No
Work Phone
Email
Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Date(s) needed for piano rental:*
Date Format: MM slash DD slash YYYY
Location piano is to be delivered to:*
Street Address Address Line 2 City State ZIP Code
Inside
Flooring*
- Carpet
- Wood
- Ceramic Tile
- Other
If "Other," Please Specify.
Sharp turns?*
- Yes
- No
(less than 6' clearance)
Length
Width
Any inside steps?*
- Yes
- No
How Many Steps Inside?*
Type of Steps
- Carpet
- Wood
- Concrete
- Other
If "Other," Please Specify.
Will the Piano Be Going Up or Down the Steps?*
- Up
- Down
- Both
Please Specify.
Are the Steps Facing a Wall?
- Yes
- No
Any Turns at the Top or Bottom of the Steps?*
- Yes
- No
Length
Width
Any Turns/ Landings on the Steps?*
- Yes
- No
Number of Landings
Length
Width
Notes
Outside
Can Our Truck Back up to the door?*
- Yes
- No
If "No," how far (in feet) will the truck be from the house?*
Path to the Door*
- Sidewalk
- Grass
- Stone
- Brick
- Other
If "Other," Please Specify.
Degree of Any Slopes
Any outside steps?*
- Yes
- No
Number of Outside Steps*
Type of Steps
- Concrete
- Wood
- Brick
- Other
If "Other," Please Specify.
Will the Piano Be Going Up or Down the Steps?*
- Up
- Down
- Both
Please Specify
Any turns/ landings on the steps?*
- Yes
- No
Number of Landings
Length
Width
Do You Have Any Photos of the Delivery Location that You Can Post? If so, How Many?
- One
- Two
- Three
Post Photo Here
Second Photo
Third Photo
Notes
How Did You Hear About Us?
- Family/Friend Referral
- Facebook
- Newspaper/magazine Ad
- Other Website
- Internet Search
- Event
- Other
Which Newspaper/ Magazine?
Which Website?
Which Event?
If "Other," Please Specify.
Thank You

Services

One-Day Rental Form

Inside

Outside

Thank You