Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone *Is this a for a Residential or Commercial establishment? *-Select One-ResidentialCommercialCompany Name *Job Title *What is your Preferred date? *What is your Preferred time window? *-Select a time Window-9am-12pm12pm-2pmDo you need this Display mounted on a wall or ceiling? *-Select One-Wall MountedCeiling mountedTV Brand *Model NumberWhat Room will this be installed in? *What is the construction of your wall concrete, brick, plaster, tile or decorative surface? *-Select One-Sheetrockconcretebrickplaster, tile or decorative surfacetile or decorative surfaceSpecial needs (Recessed in wall, behind Mirror or otherOnly the wall that the TV will be mounted onWhat is the height of the wall from Ceiling to floor, that the display will be mounted on? *TV wall onlyWhat is the length of the wall from end to end? *Only the wall that the TV will be mounted onWhat is the preferred height off the ground, that you would like your TV mounted? *-Select One-34 inches from the floor36 inches from the floor38 inches from the floor40 inches from the floor42 inches from the floor44 inches from the floor46 inches from the floor48 inches from the floor50 inches from the floor52 inches from the floorAbove 52 inches is outside of the guidelines of the American disabilities act. Please consider your ceiling height and any furniture or shelving below the TV. On the Day of the Installation. The Field Engineer will do a mockup before mounting any hardware. If you would like to change the height you may do so at that point.Is an Electrical Outlet already installed, directly behind were the display will be mounted? *-Select One-YesNoPlease note extension wires in walls are illegal. Wall fishing a TV power cable in the wall is illegal. If an outlet is not installed directly behind at the height were the TV is mounted please select no.Is there an electrical outlet directly below where the Display will be mounted? *-Select One-YesNoIf not how far is the nearest electrical outlet? *Please tell us the TV size? *Do you need a surge Protector? *-Select One-YesNoHow will we route Cables from Sources to Display? *-Select One-Hidden in wallUse Wire moldingExposed wiresNo connections necessaryDid you already purchase a mount or do you need us to provide one? *-Select One-Please add a mount to quoteI already Purchased oneHow many Source equipment will we be Integrating to your Display? *Cable box or SAT boxDVD/BLUE RAY PlayerGaming consoleA/V ReceiverProjectorApple TVMedia PCFire StickOther Brand Video StreamerSelect all that applyHow will this TV be connected to the Internet? *-Select One-WirelessHard WireNo internet Service neededHow far is your nearest Internet Router or Switch? *Do you want us to install any Speakers for surround sound? *-Select One-YesNoPlease select your Surround sound setup *-Select One-Soundbar5.1 Surround Sound7.1 Surround Sound9.1 Surround SoundWhat is the Square footage of the entire room? *Do you want us to program any remotes? *-Select One-YesNoWhat brand Remote? *Is your cable box and all source equipment currently Installed in the Location that you would like your television Display mounted or does it need to be relocated? *-Select One-YesNo I need all my equipment relocatedHow far from the current location does your cable box need to be moved to accommodate the new proposed location for the TV wall Mount Display? (feet only). *Do you already have all your HDMI Cables and any other cables that we will route from Source to Display? *-Select )ne-YesNoWe recommend 12-15 feet length cables. Depending on how high the TV will be mounted.If you need additional cables. What Type and how many? *Please upload any pictures that will aid us in the design Click or drag files to this area to upload. You can upload up to 10 files. Submit