To be able to answer you correctly we still need the following informations :
Please fill in the fields marked with an asterisk.
(*) Company Name
(*)VAT number
(*)Madam, Sir ?
(*)Your first Name
(*) Your Name
(*) YOUR ADRESS
(*)STREET NUMBER
(*) Postal code
(*)City
(*)COUNTRY
(*)Your Email Adress
(*) Your mobile phone number + the mobile number of the person picking up the equipment
(*)Mobile number of the person who will come to collect and return the equipment (if it is not you)

Below, please indicate the desired dates and times for equipment pickup and return, as well as the number of days the equipment will be used.
If you don't yet know the dates, simply enter "not yet known" in the date and time fields.

(*) Desired date and time for collection of the equipment
(*)Number of days the equipment was used
(*) Desired date and time for the return of the equipment
(*) Your Specific Request


(FOR INFORMATION) PLACE WHERE THE MATERIAL WILL BE USED
NAME OF THE ROOM WHERE THE EQUIPMENT IS TO BE DELIVERED
HALL PHONE NUMBERHALL PHONE NUMBER
FULL STREET
STREET NUMBER
ZIP CODE
CITY
COUNTRY

VENUE MANAGER FOR YOUR EVENT

NAME OF THE PERSON IN CHARGE OF YOUR EVENT VENUE
MOBILE NUMBER OF THE CONTACT FOR YOUR EVENT VENUE

MISCELLANEOUS REMARKS


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COMPANY APPLICATION FORM

WITH COLLECTION AND RETURN BY YOUR OWN

WARNING
Pickups and Returns Rentals
Only by appointment
            Call Us : +32 2 331 31 00

Solution provider for Audiovisual (Rental and Sales)

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LIVELINE STUDIO PRODUCTIONS
 
PieterMichielsstraat, 31
1601 Ruisbroek (Brussels)
Belgium
Tel : +32 2 331 31 00
Fax : +32 2 331 32 12
LIVELINE HEADQUARTERS
 
Rue de Strichon, 92
1495 Villers La Ville
Belgium
Tel : +32 2 331 31 00
Fax : +32 2 331 32 12
LIVELINE MAIN OFFICE
 
PieterMichielsstraat, 31
1601 Ruisbroek (Brussels)
Belgium
Tel : +32 2 331 31 00
Fax : +32 2 331 32 12