Office Building
Information Request Form

If you own, operate, or manage an office building, then we'd like to hear from you!

NOTE: All inputs highlighted in RED are required fields for a successful submission. We respect your privacy. The information captured will be kept confidential and will be used soley for the purposes of evaluating your eligibility for unit.

First Name: *
Last Name: *
Title/Position: *
Company: *
Phone: *
Email: *
Name of Proposed Office Location: *
Address of Proposed Office Location:
**Street Address: ***
City: *
State: *
**Zip/Postal Code: ***
Management Company Name: *
Number of Floors: *
Number of Bldg. Employees: *
Who are the major tenants in the building?
Describe the proposed building(s) as completely as possible (demographics, other amenities, proposed common area for the machine, etc.):
Please state the reasons you think this would be a good location for a DVD rental machine:

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Office Building Information Request Form

Office Building
Information Request Form