Thank you for your interest in a Xerox Short Term Rental. Please complete the following information.
Short Term Rental Contact Form - required
Contact Information:
First Name 
Last Name 
Job Title 
Company Name 
Street Address 
City 
State/Province 
Zip/Postal Code 
Telephone Number 
Fax 
Email Address 
Equipment Requirements:
List Equipment Requirements: 
Features Needed:
 
 
 
 
Start Date of Rental 
End Date of Rental 
City Where Rental is Required 
Additional Comments
 
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