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Service Request Form

 

 

To request a service call, please complete the following information:

Customer Information
            * Indicates required field

* Name 
* E-mail
* Phone Number    
* Street Address
* City     * State * Zip

Computer Information

* Manufacturer  
   if OTHER, please list
  Model

* Operating System    
    if OTHER, please list

Processor Memory (RAM) MB

Service Requested

* Type:     On-Site Pick-Up

* What do you need done?
Repair
Upgrade
PC Tune-up

Network Installation
Other - Please List:

* Brief description of the problem:

 

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Copyright © 2007
Last modified: The Computer Geeks
Last modified: June 05, 2007