Intake form

Help us serve you better

Name *

Email address *

What service are you interested in?

Please select at least one option.

Computer Repair

Sales of Computers and Accessories

Teaching

Programming

What type of computer do you need assistance with?

Please specify the brand of your computer or accessory.

What issue are you experiencing with your computer or accessory?

Preferred method of contact for follow-up.

What is your availability for a consultation?

Which service or services are you interested in?

Please select at least one option.

Computer repair

Computer sales

Computer programming lessons

Service title 7

Service title 8

Additional questions or comments

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