Information about my phonograph:

Make: Please select the make (brand) of your phonograph Edison Victor Columbia Other (please specify on the next line)

If other, please specify:

Model &serial number (if known):

Type of Phonograph: Please specify what type of machine you have Cylinder Machine Disc Machine I don't know

Cabinet: Please select a category that best describes your machine Tabletop (it sits on a table) Upright Floor Model (sits on the floor, taller than it is wide) Console Floor Model (sits on the floor, wider than it is tall) Credenza Other (specify below)

If other, please specify:

Type of Wood: Please select what type of wood th cabinet is made of Mahogany Oak Walnut Other (specify below)

If other, please specify:

Information about what I am looking for:

I Need: Please select a category that best describes your needs Repairs Parts Repairs and parts I'm not sure, so let me explain below

Please use this area to describe what you need, being as specific as possible.

Information about me:

Name:

Street:

City:             State:              Zip Code:

Phone Number:                 Fax:

Email Address:

I prefer to be contacted by: Please select how you prefer to be contacted Phone Email Either phone or email

When you are finished completing this form, please click the "submit" button below.

Thank you for your request.