Computer Service Request Form Ver.1.10

1. Location of Issue

   Corporate ParkWest Open Door Bay CLub Brookfield Cherry Bud Chingford Daytona Georgetown Grove City Hafton Harris Hiler Hunter Kenbrook Kossuth Mallard Maple Bend Mark Twain Mead Morse Rd Niblick Norris Orchard Partridge Red Ash Redmond Sanlin St. Joseph Santiago Sunset Sturbridge Taunton Way Weyant
   

2. Which type of computer are you using?

   Desktop Laptop PDA (smartphone, treo, windows mobile) Cisco VOiP Other None I don't know
   

3. CIS related issue/concern

   Fax Machine Issue Computer Crashed/Froze/Locked Up Known Virus or Spyware issue Cannot Surf Internet Cannot send/recieve Email Cannot Print to OKI Cannot Print to Local Printer Cannot Print in Correct Format Cell Phone Issue Software Training Request Cisco Phone Issue Move Files/Email/Documents to another computer Software/Hardware Request Software Install Issue Software Issue Software Configuration Website/Computer login Issue Website New Page Request Other(explain in comments box)
   

4. Work Email Address

   
   

   First and Last Name (if you do not have approved email form)*

    

5. Comments/Further Explanation (if needed)

   
   

* Approved email form: @cchs,@pwca, @scl-col.org