Quantity *

Rental Term: How long are you going to use the machine? *

Function: Is it a printer only or an MFP (print/copy/scan)? *

• Copiers
• Scanner
• Printers
• Plotter

Color interest *

• Black and White
• Both
• Not sure

Model: Do you prefer desktop or floor standing? *

• Desktop
• Floor Standing

Paper Size: *

• Letter (8.5 x 11)
• Ledger ( 11 x 17 )
• Legal (8.5 x 14)
• Cover stock

support? Computer Pick-up

Feature: *

• Finisher
• Fax
• Auto Doc Feeder
• Other

Toner Allowance: Average Monthly Print/Copy Volume? *

Delivery Date *

Pick-up Date *

Need network setup? *

• Yes
• No

Need IT tech support? *

• Yes
• No

Computer OS: *

• Windows
• MacOS
• Linux

Venue: *

Email *

Name *

First

Last

Phone

Address *

Address Line 1

Address Line 2

City

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Zip Code

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