Name *
Contact Phone Number *
Contact Email *
New or Pre-Existing Construction? * New ConstructionPre-Existing
Property Type * HospitalityHealthcareMultifamilyStudent LivingSenior LivingInstitutionalRestaurant/BarOther
Property Name *
Property Address *
Number of Floors *
Number of Rooms / Units *
Number of Suites *
Number of Public Area TVs *
Current Service Provider * Cable TVDish NetworkHughesNetDIRECTVOther
Type of Service Requesting? * DIRECTVWi-FiBothOther
Currently Under Contract? * YesNo
Time Remaining in your Contract? *
Make/Model of Current TVs *
Do You Need to Purchase TVs for this Property? * YesNo
Additional Comments
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