Please enable JavaScript in your browser to complete this form.Company // Organization Name *1. Digital Wireless Headset / Wig Mic @ $125/ea. per weekNone456789101112131415161718192021222324252. Digital Wireless Lavaliere @ $85/ea. per weekNone456789101112131415161718192021222324253. Digital Wireless Handheld @ $85/ea. per weekNone456789101112131415161718192021222324254. Digital Wireless Corporate Headset @ $85/ea. per weekNone456789101112131415161718192021222324255. G3/G4 Wireless Theatrical Headset / Wig @ $95/ea. per weekNone456789101112131415161718192021222324256. G3/G4 Wireless Lavaliere Mic @ $65/ea. per weekNone456789101112131415161718192021222324257. G3/G4 Wireless Corporate Headset @ $65/ea. per weekNone456789101112131415161718192021222324258. G3/G4 Wireless Handheld Microphone @ $65/ea. per weekNone45678910111213141516171819202122232425Wireless In-Ear Monitor $85/ea. per WeekNone45678Sennheiser Wireless Antenna Combiner with Directional AntennasnoneRack of 8 ($200)Rack of 16 ($300)Rack of 24 ($400)AA Batteries - 20 for $11.80none20406080100120140160180200220240260280300Date Needed to Arrive? *Date you will send back? *Contact Name *FirstLastEmail *Business Shipping Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeBilling Address is Different than Shipping AddressAdd Billing AddressBilling AddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email Address (used for Tracking and Account info) *We do not share your information! Confirm Email Address *Check here if you are sending a check. Must be received at least 3 days prior to shipmentWe are sending a checkCredit card is still required for security purposes. Credit Card Number *xxxx-xxxx-xxxx-xxxx (no Discover) | THIS IS REQUIRED TO PLACE AN ORDER Card Expiration Date *MM / YYYY CVV2 (security code) *Code on back of cardOrder/Quote Number (If Available)Comment or MessageBy checking the box below, I agree that I have read and agree to the terms and conditions of the rental contract attached below. I also understand and agree that I am fully responsible for the equipment while it is in my possession. *I agreeThe wireless microphones are very delicate and capable of breaking or becoming damaged if mistreated. If the microphones are returned deformed, cut, torn or damaged from misuse, you will be charged for the replacement, necessary repairs or cleaning fees. *I accept these termsYou agree to not use makeup, tape or any other substance on the microphone cable, capsule, frame or connector. Any makeup that is used and stains the microphone will be billed to replace the entire microphone. Any tape, tape residue, makeup or products that require Beamworks to do more than a simple cleaning process will be charged a cleaning fee * *I accept these termsSignature *Clear SignatureName of Signee *CommentSubmit Download Wireless Contract