WEBS-MT/R-OP4(OP5) Preference Form

Thank you for your order, which includes model WEBS-MT/R-OP4(OP5) tower(s).

This order cannot be processed until we receive the following information.

Please fill in the answers below and then press the submit button.

Fields marked with * are required.

Customer Information

Company: *

Purchase Order #: *

Company you ordered from:

If you did not order directly from Talk-A-Phone, enter the name of the company you ordered from

Your Name: *

Your Title: *

Phone Number: *

Email: *

(e.g. john@example.com)

Order Information

Quantity: *

In what voltage do you want the unit?: *

What color shall we paint the tower(s)?: *

Download paint color chart

Other Color:

What should the lettering read on the sides of the unit(s)?: *

Other Lettering:

What color reflective lettering should we use?: *

Download lettering color chart

Other Lettering Color:

Shipping Information

Requested ship date for tower(s)?: *

(e.g. 12/31/10)

Would you like the mounting equipment and other parts shipped in advance?: *

Note: towers shipped separately via motor freight.

Do you need to be contacted before we ship the tower(s)?: *

Does the freight company need to notify anyone prior to delivery?: *

Additional freight carrier charges will apply to schedule an appointment. Calls without appointments are for convenience only and are subject to driver's discretion.

Do you need a truck with a lift gate?: *

Additional freight carrier charges will apply.

Shipping Address for tower(s) if not listed on PO:

Note: unless other instructions are given, bolt kits and other small parts will be shipped to the address on the purchase order.

Special Instructions:

Support

WEBS-MT/R-OP4(OP5) Preference Form