WORKSHEET & CONTACT US
To begin the process of determining your audio, video and design needs, please complete and submit the form below. A home theater professional will contact you in 1 to 2 business days to discuss your project.
*These fields are required.
*Name:
*E-mail:
*Address:
*City: *State: *Zip:
*Phone:
Best time to contact you: Daytime Evenings
Room Type: Living Room Media Room Dedicated Theater Other:
What are the approximate dimensions of your room? ft. by ft.
Primary Purpose of the Room: Movies Sports/Live Action TV/Everyday Use Basement Recreation Room
Video Options (Please check all that apply):
1080p Projector/screen 92"
1080p Projector/screen 110"
1080p Projector/screen 123"+
Flat panel 42-47"
Flat panel 52-63"
Flat panel 63"+
Other:
Speaker Options:
Tower speaker package
Mounted on-wall speaker package
Mounted In-wall or in-ceiling speaker package
Multi room speaker package
Optional Services (Please check all that apply):
Multi room audio/video
Acoustical room wall panels
Stadium seating
Custom millwork or cabinetry
Light fixtures or lighting control
Turn-key room design/build (recommended)
ISF video calibration/HAA audio calibration		 Anticipated Level of Investment:
$5,000-10,000
$11,000 to $18,000
$19,000 to $25,000
$26,000 to $45,000 (includes interior design and partial room design/build potential)
$45,000+ (includes interior design and full room design/build potential)
When are you planning to purchase your new system? Immediately Within 30 days More than 30 days/Unsure
Questions or special requests:


Custom Home Theater | Sharpsburg, GA 30277 | 678-429-0072 | sales@CustomHT.net