Equipment Reservation Form
Click below to get your rental started!
The information we collect will always be kept confidential.
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Hey there! Are you a Returning Customer or New Customer? *


 
Okay! First you'll need to register, then you can reserve your gear.

 
What kind of entity are you registering on behalf of? *


 
Great! Let's move on with your individual registration.

 
What's your first name? *

 
And what's your last name? *

 
What's your phone number, {{answer_69098331}}? *

 
Awesome. Let's move on with your organization registration.

 
What's the organization's name? *

 
What type of entity is the organization? *


 
What's the phone number for {{answer_69103009}}? *

 
Now we need to know your billing address.

 
Street? (Line 1) *

 
Street? (Line 2)

 
City? *

 
State? *

 
Zip Code? *

 
Next we'll need the primary contact for {{answer_69103009}}.

 
What's the contact's first name? *

 
What's the contact's last name? *

 
What is the contact's title/position? *

 
And what's the contact's phone number? *

 
Excellent. Would you like to add an Authorized Representative? *

Authorized Representatives are secondary contacts that are permitted to pick up and return equipment for a registered organization.
     
 
Please fill out the same information for the Authorized Representative at {{answer_69103009}}.

 
What's the Authorized Representative's first name? *

 
What's the Authorized Representative's last name? *

 
What is the Authorized Representative's title/position? *

 
What's the Authorized Representative's phone number? *

 
Would you like to add another Authorized Representative? *

Authorized Representatives are secondary contacts that are permitted to pick up and return equipment for a registered organization.
     
 
Please fill out the same information for the 2nd Authorized Representative at {{answer_69103009}}.

 
What's the 2nd Authorized Representative's first name? *

 
What's the 2nd Authorized Representative's last name? *

 
What is the 2nd Authorized Representative's title/position? *

 
What's the 2nd Authorized Representative's phone number? *

 
Please answer a few more questions for us to determine if you qualify for insurance exemption.


Insurance exempt customers will not be required to purchase insurance on orders with a replacement value less than $10,000. If the total replacement value is beyond $10,000 or if you do not qualify for insurance exemption, then you'll need to make a deposit or get at minimum general liability insurance on the equipment. Include Eleven04 Productions, LLC on the insurance certificate.

Please call us (312-265-0616) if you have questions - we'd be happy to help.


 
Please provide some work related references. *

Include the phone number + email address for each one.
 
How many years have you been working as a filmmaker? *


 
What role do you usually take working as a filmmaker? *

 
Please provide a link to your professional portfolio below. *

Make sure to only provide the work that you have made major contributions in.
 
Do you have a website?

If not, or if website is the same as portfolio, you can skip this.
 
If you have an IMDb page please jot that down too.

If not, you can skip this.
 
Terms & Conditions *

1. New Renters must show up in person for their first rental in order to collect final information. After your first visit you are free to have a representative pick up gear for you.

2. A submission of Insurance Exempt Application does not guarantee an approval. Eleven04 Productions, LLC reserves the right to explain its selection process.

3. A submission of this form does not guarantee the availability of the equipment. The availability of equipment is always changing and we follow the first come and first serve rule.

4. The applicant or the preparer of the applicant acknowledges that to his/her best knowledge, the information he/she filled out is accurate and true. Eleven04 Productions, LLC is not responsible for any damage or legal obligation that is caused or related to the incorrect or inaccurate information on this form.
     
 
One last thought! How did you find out about us? *

If you were referred by a friend please mention their name!
 
Okay! Let's get your reservation started.

 
What's your first name? *

 
And your last name? *

 
So what equipment would you like to reserve, {{answer_68941659}}? *

Please be specific! Reference our inventory at www.eleven04.net
 
What day would you like to pick up your gear? *

 
Will you need a prep session for your equipment? *

Upon request, we provide up to 2 hours prep session at our location for renters to set up and prep the equipment. The prep session is right after the scheduled pick-up time. Due to limitations a prep session is not always guaranteed.
     
 
What day would you like to return your gear? *

 
How do you plan to handle insurance on this order? *

If you do not know if you are insurance exempt - please select D.

 
Awesome! Is there anything else we should know?

Thank you, {{answer_68941659}}!

One of our rental technicians will contact you as soon as possible via email to confirm your reservation for {{answer_68942224}}- {{answer_68943081}}!

If you are a New Renter then you will also receive registration confirmation and your insurance exempt status within that email as well.

We hope to see you soon!
DONE
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