HiTech Computers Contact Form

Which Operating System do you have? (Choose one of the following options):

Windows 95 Windows 98 Windows 2000 Windows NT Windows XP Mac/OS Don't Know

Briefly describe for us the problem you are experiencing?

Enter the date you first noticed the problem:

-- mm/dd/yy

Were any changes made recently to the software or hardware on your computer?

Yes
No
Not Sure

If Yes - Who made the changes to your system and what was modified?

Please provide ALL of the following contact information:

Name
Title
Organization
Street Address
Address (cont.)
City
State
Zip/Postal Code
Urgent Reply Needed?	(Yes or No)
Work Phone
Home Phone
FAX
E-mail	*required
URL

From the contact info above - What is the most convenient way to contact you? (Select any of the following options that apply):

Business Phone
Home Phone
Fax
Email
Mail