Advanced Data Projection

Customer Questionnaire Form
Please complete our Customer Questionnaire Form below and one of our expert sales consultants at Advanced Data Projection will contact you soon to help you find the best solution for your audio visual equipment needs at a price that fits your budget.

	Please enter all the required fields below and then press submit to send your information to us. The required fields are marked with an *
First Name:	*
Last Name:	*
Job Title / Function:
Company Name:	*
Industry:
# of Employees:

E-mail Address:	*
Phone Number:	* Ext.
Fax Number:
Street Address 1:	*
Street Address 2:
City:	*
State:	*
ZIP:	*
Preferred Method Of Contact:	*
How did you find us:

1. What is your particular need(s) for audio visual equipment? *
Rental Purchase Installation Other (please specify):

2. How many projectors are you interested in renting, purchasing or installing? * * If your answer is None, then go to question # 7.

3. What is the primary use for the projector(s)?
Simple presentations (i.e. Powerpoint) without detailed text or high-end graphic images Detailed presentations with spreadsheets and/or small type Highly detailed presentations or CAD application display with high resolution Mixed use including video projection needs Video projection only use Home-Theater use Other (please specify):

4. For what size audience will the projector(s) primarily be used?
Small - i.e. board room or home theater use Medium - i.e. classroom or conference room Large - i.e. auditorium or large hall (church)

5. Will you be able to control the lighting levels in the room(s) where you will be using the projector(s)?
Yes - will always be able to darken the room Yes - will somewhat be able to darken the room No - will not be able to control the room lighting

6. Will you need to purchase a portable projector(s)?
Yes - prefer the lightest model (2-3 lbs.) Yes - prefer a light model (4-6 lbs.) Yes - portable (7-10 lbs.) No - this will be installed in a fixed location No - this will be for rental use only

7. What is your estimated total budget for the projector(s) purchase and/or installation(s)? *
$ 800 - 999 $1,000 - 1,499 $1,500 - 1,999 $2,000 - 2,999 $3,000 - 3,999 $4,000 + Not sure, please advise based on my needs For rental use only NOTE: Your desired features and usage requirements will determine the products and prices available. While features like brightness, weight desired and detail of the display will all impact pricing, $600 is the lowest approximate price available from any of our manufactures.

8. What is your renting, buying or installing time frame? *
ASAP In one week In two weeks In one month In two months More than two months

9. How would you best classify your business or organization? *
Small to mid-size Business (1-500 employees) Large Business (500+ employees) Government Agency (Federal, State or Local) Educational Institution (Public or Private) Non-profit Organization or Church Group Other (please specify):
*NOTE: We only serve U.S. businesses at this time.*

10. Are there any additional features you are interested in for your projector(s)?
Screen - width desired: Feet Carrying case Ceiling mount Long-throw lens - distance: Feet Wide-anlge lens - distance: Feet Wireless networking capability Built-in PC card reader Remote mouse capability Other (please specify):

11. Please describe in detail additional requirements like specific model numbers, desired resolution, brightness, aspect ratio or any other audio visual equipment that you might have a need.
Note: There is a 1,000 character limit for this answer.

Phone #: (614) 865-0776
Email Address: adp@columbus.rr.com

Corporate Headquaters Address

470 Olde Worthington Rd., Suite # 200

Westerville, Ohio 43082

Office Hours: Monday - Friday 8:30am - 5:30pm EST
By Appointment Only! Please No Walk-ins!

Shipping & Mailing Address

7385 North State Route 3, Suite # 124

Westerville, Ohio 43082