Hearing Loop System Enquiry Form Help us plan your Induction Loop project. Fill in the form below, email your floorplans or specifications to firstname.lastname@example.org and we'll provide you with a bill of materials and quote. Or click here to download a PDF copy of the form. First Name * Last Name * Company Name * Email Address * Business Phone * Project Name Approximate Date of Installation Project Stage Quotation Bill of Materials Choose Best Fit Description Room / Auditorium Portable / Non-Permanent System Elevator / Lift One-to-One Speech (Counter, info desk) Vehicle Other (please indicate) Audience Listening Height Seated Height (Approx. 1.2m) Seated and Standing Height (Dual Use) Standing Height (Approx. 1.7m) Type of Mounting required Rack Mount Under Counter Wall Mount Vehicle Enclosure Lead Cable (Distance between Amplifier and loop - close approximation) Additional Description Please describe the application as accurately as possible. Remember to include the number of systems required, width and length of each coverage area, intended position of the loop. Installation Method Please indicate the intended method of loop installation below. Audio Inputs Describe any audio systems that will be used as an input to the loop system. (for example in concrete, under carpet etc) Spill Interference Will there be any other loop systems within 7 - 10m of the loop? Please give details - is confidentiality important? Metal Computer Floor (metal clad floor tiles) Mesh Reinforced Concrete Floor Metal Grid in Ceiling Metal Beams or Panels Close to Cable Location Steel Deck Reinforced Floor Metal Frame Building Metal Ceiling Tiles Other Construction properties of a room will affect your loop design. Please identify the following wall and floor properties. Application Please describe the application, including the number of systems required, width and length of each coverage area and intended position of loop.