Service Call Form

To contact CES for a Service Call,
Please provide the following information about yourself or business!
(* Indicate required fields)

*First Name *Last Name

Company

Street address

Address (cont.)

City

State/Province

Zip

*Work Phone
(if no work phone, Please enter home phone.)

Home Phone

Cell Phone

*E-mail

Client Type Personal     Business

Frist Time Client (Please check this if you are a new client)

Method of payment Check         Visa       Master         Net Terms (Already Established)

Onsite service specific: Is Emergency
Call Customer (call before we come out to service)
Need to pickup computer

Drop off at CES           Onsite Service (please enter location)

Location of office or residence for service call.

Requested date & time range for the service or Drop off at CES:

         Date:                From To

Directions to the call from Route 26 and U.S. 15.

Work order comments:
(What is the nature of the problems or service call?)

            Is your data back up? (if yes, Please check this box and answer below question.)

            What format is it backed up?

System Hardware Configuration

Computer Drives

Computer Type: Magnetic Media:

PC Brand:           Drive                Type                 Size                 Free Space

Processor Type: HDD1

Processor Speed: HDD2

RAM (amount):

System Software Configuration

Operating System: Domain:

Machine Name: Workgroup:

IP Address: Gateway:

Subnet: Protocol:

Software:

*Service Rates: Inhouse service $75.00/hour. Inhouse Forensic data recovery $85/hour.
                               Client site computer service $95/hour. Client site Networking $105/hour.
                   "Free pick service" for all drop off (Inhouse) work orders placed via the cesitservice.com web page.

For emergencies service calls please contact
Computer Enhancement Systems Store, 301-620-1580.