Service Request Form

 
On-site rates: $45.00/hr (1 hour min)* 15 min billing after the first hour ($11.25/15min) *For Standard Windows Operating Systems only, Mac and Server Operating Systems may be higher*
 
 
Is service request for your home or business?
 
What type of Internet Connection do you have? Cable,DSL,Modem,T1,None,Other
 
 
 
Describe your service needs,Please include details, Operating System version,model of machine,Etc.
 
Tell us how to get in touch with you.Phone,Cell, Email
 
Land Line Phone
 
Cell Phone
 
Email
 
 
 
Other Contact method
 
Prefered return call time, P.M.,A.M.
 
Please contact me as soon as possible regarding this matter
 
 
 
Other, Comments or Questions?