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Onsite Service Request Form

Our standard service rate is $90.00 per hour with a minimum fee of $40.00. An 8 hour block time can be purchased at a special rate of $70.00 per hour.
Please consult with one of our service representatives for further service rate information.

* denotes required fields
Is this for your home or business?  
* First name:
* Last name:
Company Name:  (If Applicable)
* Address:
 
*City:
* Prov:
* Postal Code:

We may be able to contact you quicker if we have more than one phone number
Home Phone:
Work Phone:   Ext  
Cell Phone:
Choose your main phone line:  

* Email:
* Confirm Email:
How many machines are at this site?:  
Operating system(s) in use :
Select ALL the operating systems that apply:
 
UnknownDOSLinux
MS ExchangeNovellWindows Tablet PC
Windows 2000 Windows 95Windows 98
Windows MEWindows NTWindows NT Server
Windows 2000 ServerWindows Server 2003Windows XP Home
Windows XP Media Center EdWindows XP Pro  
What type of Internet Connection do you have?  

Product Information
Brand name:
Model number:
Serial number:  (If Applicable)

Describe your service needs:
Please include details such as your Operating System version, notes about any problems experienced and any other relevant information:

   





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