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:.

Midi Required

Yes
No

Yes or no

An adjustable artist bench will be provided unless otherwise noted.

Venue Name: *

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

NOTE: Piano Mover cartage fees are significantly lower if requested delivery and pickup occur during normal business days / hours. 2 hour time window preferred

Delivery Date: Day of Week

Delivery Time:

Pickup Date: Day of Week

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):

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