Your Name (required)

Your Email (required)

Contact Number (required)

Fax Number

Please provide details of the lift requirements:

Maximum load (kg)

Distance from obstacle (meters)

Height required (meters)

Obstacle height (meters)

Radius (meters)

Date/s requried

Time/s required

Contact number on-Site

Site Address

Please provide a short description of the item/s & indicate the dimensions:

Any other details about your lift?