Please complete the information below.
 
Name:
E-mail:
Address (street, City, State, Zip)
Phone:
Best time to contact you:
 Daytime  Evenings
Room Type:
 Living Room  Media Room
 Dedicated Theater  Other
What are the approxmiate dimensions (width by depth) of your room?
Primary Purpose of the Room:
 Movies  Sports/Live Action
 TV/Everyday Use  Basement Recreation Room
Video Options (Please check all that apply):
 LCD
 DLP
 LED
 Plasma
 Projection Screen
Speaker Options:
 Floor Standing
 Mounted ON wall or ceiling
 Mounted IN wall or ceiling
 Bookshelf Speakers
 Combination
Optional Services (Please check all that apply):
 Acoustical Room Treatment
 Stadium seating
 One Touch Remote System
 lighting and/or automated control
 Service Plans
Anticipated Level of Investment:
 $0 to $15,000
 $15,000 to $25,000
 $25,000 to $40,000
 $40,000 to $65,000
When are you planning to purchase your home theater?
 Immediately  Within 30 days  More than 30 days/unsure
Questions or special requests:
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