Piano Request Form

PIANO REQUEST FORM

Please note this form is not a confirmation. The information completed below will be used for quoting purposes only. Please complete the entire form to receive the most accurate quote.

Today's Date:

Show Date(s):

Requester Name:

Requester Phone Number

Requester Email

Performer / Artist:

Piano Model Needed:

MIDI Required

An adjustable artist bench will be provided unless otherwise noted.

Venue Name:

Venue Address:

Onsite Contact Name:

Onsite Contact Phone

Load in description:

Stairs:: Yes / No, if YES how many

Stage: Yes / No, If YES, height

MOVING INFORMATION

Delivery Date

Delivery Time:

Pickup Date

Pickup Time:

TUNING INFORMATION

Do you need a tuner : YES/NO, (If YES, please allow 1.5 hours for tuning)

Tuning Date(s):

Tuning Preferred Times(s):

BILLING INFORMATION

NOTE: REQUESTOR is responsible for cartage and tuning expenses unless previous arrangements have been made.

Bill To:

Billing Address:

Billing Contact Email

Billing Contact Phone

Message

Piano Request Form