• Find a Local Representative Call 1.800.321.8105 • Find a Local Dealer • Request a Product Catalog Green Product - LED Indoor Menu Boards Drive-Thru Menu Boards General Signage Displays Stock & Custom Graphics Replacement Parts Pepsi Bottlers & Vendors Coca-Cola Bottlers & Vendors Dr Pepper Snapple Group Bottlers & Vendors Please complete every field of the following form and fax a complete copy of our menu to 775-882-5210. Your first layout will be free and there is no obligation to purchase. you will receive your layout in 3-5 business days. if you need assistance filling out this form or have any questions once submitted, please contact our Customer Satisfaction Department at 1-800-321-8105. BEFORE IMPACT CAN PROCEED WITH YOUR FREE LAYOUT, A COMPLETE MENU MUST BE FAXED TO 775-882-5210 OR EMAILED TO INFO@IMPACT-POP.COM AS AN ATTACHED WORD, EXCEL, OR PDF FILE. Customer Information Business Name: Contact Name: Address: City, State, Zip: Phone: Fax: Email: What type of product are you interested in? Indoor Outdoor Both Graphics Is this a new purchase or for an existing system? width x height New System Replacement Parts Have you seen an example of a menu board you would like your system to resemble? State a specific source: What type of system are you considering? Magnetic Illuminated Non-Illuminated Overall space available for system (indoor only): width x height Hanging Method (Indoor Only): Wall-Mount Ceiling Hung Both Changeable Pricing: Yes No Describe your decor or color preference: Estimated Installation Date: Estimated Budget Range: How did you hear about us? Internet Search Referral Trade Show Other Name & Date of Tradeshow if applicable: Is this property part of a chain or a franchise? Chain Franchise Neither Notes and Comments: