Contact
Information Are you ordering for your Home or Office? Select One Home Business Home Office *Full Name Company Name (If Applicable) *Address *Address Line 2 (Optional) City *State California Select One Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Marianas Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Virgin Islands Washington West Virginia Wisconsin Wyoming *Zip Code (5 digit) *Email Address *Phone Number (xxx) xxx-xxxx or
xxx-xxx-xxxx Other Phone (xxx) xxx-xxxx or
xxx-xxx-xxxx *Best time to contact you? Preferred
day for appointment (check all that apply)
Please
understand that we will do our best to meet your scheduling needs,
but due to the high volume of appointment requests, these
preference(s) are intended to serve only as guidelines.
Anytime Monday Tuesday Wednesday Thursday Friday Saturday Sunday
(if available)
Do
you need After hours, Holiday or Emergency support?
Select One
Yes No
Support
Information What type of computer do you have? Select One Desktop PC Laptop PC Backup Device Other If other please specify Which operating system are you using? Select One Windows 7 Windows XP Home Windows XP Media Center Windows XP Pro Windows Vista MS Exchange Windows Server 2003 Windows Small Business Server 2003 Windows Server NT Windows 2000 Windows ME Windows 98,95 Mac OS X Other If other please specify Which web browser(s) are you using? Select One AOL Google Chrome Internet Explorer Firefox Opera Other If other please specify Do you have any firewall software installed? Select One Yes No I don't know If yes, which one? Select One McAfee Norton Symantec Zone Alarm PcTools Other Which Internet Service provider are your using to connect to the internet? *What services or solutions are you interested in? (Please select all that apply) Hold
down the Ctrl Key to select more than one option On-site
Technician (hourly repair) Diagnostics
and Troubleshooting After
Hours Support(7pm-10pm) Emergency
Support Holiday Support Remote
Support Business
Recession Special Computer
Basic Installation and Setup Data
Backup Data Transfer Online
and Home Courses On-site
(one-on-one) 1 hour Training On-site
PC Tune-up and Optimization On-site
PC Tune-up and Optimization (2 for less) Operating
System Installation and Upgrades PDA,
Peripherals and Windows Devices Premium
Computer Installation and Setup Quarterly
PC Tune Up Loyalty Recovery
CD Backup Plan Software
Installation System Restore Virus
and Malicious software Removal Virus
Protection Plan Wireless
Network Security Safeguard Wireless
Networking Installation (1 device, up to 2 computers) How many machines are at this site? 1 2-4 5-10 11-20 20+ *Please describe the problem in as much detail as possible.
Things
to mention:
Have you been able to use these features in the past without problems (on this computer)? Select One Yes, I've never had this problem before No, I got this problem last time I have always had this problem This is my first time using this Please copy and paste any error messages you received into this box: Image Verification
