Please fill in the blanks below and submit

What is the computer problem?

What type of problem are you having with your computer?

Network/Internet Hardware Program Software Needed

What type of computer is giving trouble?

Please enter your name, e-mail address and school:

Name     










E-mail   










School

How urgent is this request?

Immediately Soon as Possible No Rush

Please give a description of the problem:

What additional equipment do you need?

What day are you submitting this request?

FORM SUBMISSION

Thank you for taking the time to fill out the request. I will get to the problem as soon as possible.