Customer Information Request Form

How did you learn about our company?
What is the name of your organization?
Main contact name:
Title:
Street Address:
City/State/Zip/Country:
Email Address (required):
Website:
Telephone number (required):
Fax number:
What type of body style do you prefer?	Enclosed Open-air Removable window panels
What type of fuel do you prefer?	Diesel Green Diesel Compressed Natural Gas Liquid Natural Gas Propane Gasoline Hybrid Electric Other
What passenger layout do you prefer?	Seated PAX Standing PAX
Which model(s) interest you the most?	California San Francisco Low Floor Golden Gate Mini Trolley
Will you require a wheelchair lift?	Yes No Maybe
Which Popular Equipment Options interest you?	Farebox Bicycle Rack LED Ropelights LED Destination Signs Rollercurtain Destination Sign Remote Control Mirrors Recaro Seat USSC Seat Bostrom Seat (std)
How many trolleys do you now have, if any? Year & Manufacturer?
How many trolleys will you require?
When will you require trolley delivery?
What is the purchase decision timeframe?	Within 90 days 3-6 months 6-12 months 1-2 years Not sure when, if ever
For what type of transportation will these trolleys be used?
Your preliminary per-trolley budget range?	Under $100k $100-150k $151-210k $211-250k Over $250k Under $50k (used) No budget yet
	New Used
Operation:	Year Round Seasonal
What is the tentative funding source?	Lease Loan Federal Grant (FTA) State or Local Grant Private Funds Other
Please list any other special requests/conditions you may have:
Information Request submitted by: (type as much as needed)