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Work Order Note For Our Customers: Onsite Repairs: Copiers, Printers, Fax Machines, Desktops and Local Networks Inhouse Repairs: Laptops, Desktops, Projectors, Fax Machines and Printers The purpose of the this WorK Order Form is to arrange an appointment to receive repair service or make the arrangement to have your hardware pickup for repair by Computer Service or our affiliate partners. Online Work Order Form EQUIPMENT TYPE Equipment Type Desktop Computer Laptop Computer Apple Machine Projector POS Monitor Printer Copier Fax MAKE MODEL SERIAL NUMBER UNDER WARRANTY? Yes No PLEASE DESCRIBE THE PROBLEM IN DETAILS. IF YOUR COMPUTER IS PASSWORD PROTECTED PLEASE PROVIDE PASSWORD ARRANGING Select Pickup for repair Send a tech to repair onsite I am shipping it in I will bring it in myself Have UPS Pickup CONTACT / PICKUP TIME 10-11am 11-12noon 12-1pm 1-2pm 2-3pm 4-5p APPOINTMENT FOR Select Monday Tuesday Wednesday Thursday Friday YOUR NAME COMPANY OR DEPARTMENT PHONE OFFICE PHOME HOME CELL EMAIL ADDRESS ADDRESS SUITE / APT CITY STATE Select State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dist. of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Mariana Islands Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP ADDITIONAL REMARKS HOW DID YOU FIND US Select On the Internet Yellow Pages Refferl   Limitation of Liability: In no event 1 Computer Services be liable for any loss of user data, use, revenue or anticipatory profits, or for any direct or consequential damages arising out of or connected with service, sales or operation.   FOR THE LAPTOP, LCD MONITOR, PRINTER, PROJECTOR AND COPIER PLEASE SHIP TO OUR OFFICE IN 5501 Seminary Rd Suite 1012-South Falls Church VA 22041

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