Residential Ticket

Residential Service Ticket

Please provide the following information:

*First Name
*Last Name
Organization
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.)
What is the make of the computer?
What is the model # of the computer?
What operating system is being used on this computer?
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 - (Home & Office) Other
Please provide a brief description of the service you require.

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