Business Ticket

Business Service Ticket

Please provide the following information:

*First Name
*Last Name
*Business Name:
*Your Job Title
*Street Address
Address (cont.)
*City
*Province
*Postal Code
*Work Phone
Home Phone
Other Phone
FAX
*E-mail
Web Page

What is your preferred method of contact?
Would you like 4 Hour Response Time for $75 extra?		(Service Orders opened after 12:00 PM site local time will be serviced the following morning. 4-Hour service may not be available for all instances or in some locations. If the technician does not arrive within four business hours, the uplift will not be charged.)
How many computers at location?
What operating systems are being used at this location?		To select more than one criterion per box, hold down the Control key (Windows) or the Command key (Mac) while selecting.
Is there virus, spyware and adware removal software installed?
If so, what is the name of the application?
Select any of the following support you require:		Computer Setup Networking Upgrading Components Maintenance Training Other
Please provide a brief description of the service you require.

Private Cable Television Solutions for MDU's www.mdutelevu.com