Home Theater Information

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Cohens Electronics and Appliances, Inc.
2515 Eastern Blvd.
Montgomery, AL 36117
334-277-8890

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Alabama Department of Public Health

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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