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Advanced Check-In

Please fill out as much as you can. If you don't know or you aren't sure just don't answer. It's okay, we'll get it when you come in to the shop.

First Name: A value is required.   Last Name: A value is required.
Member?
Yes No
     
Street: A value is required.      
City A value is required.      
State: A value is required.   Zip Code A value is required.Invalid format.
 
Phone1: Invalid format.A value is required. Phone2: Invalid format. Email: Invalid format.A value is required.
Computer:
Desktop Laptop Other
Other:
Make:   Model:   Serial Number:
Please provide a brief Description of your problems :  A value is required.Minimum number of characters not met.Exceeded maximum number of characters.
   
Please list all passwords(if none put "None"):
Do you have a current Backup of your data / files?
Yes No
   
Would you like a Backup of your data / files on DVD?
Yes No
 

Do you use any of the following programs?
Windows Mail     Outlook Express     Microsoft Office     Canon / Kodak     Quicken     Quickbooks

We backup your Desktop, Favorites, My Documents, My Pictures, and My Music folders.
Do you need any other files saved?
Does your computer turn on?
Yes No
    Is your screen cracked?
Yes No
Does Windows completely boot up?
Yes No
  Do you think you have a virus?
Yes No
Can you access the internet?:
Yes No
  Would you like Priority Service?
*additional charge of 50.00 for immediate service.
Yes No

How did you hear about us?:
   
 
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