Computer Services for You, LLC
           Request Form


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We work in Bergen, Passaic and Morris Counties in New Jersey.  If you do not live in one of these counties then give a call (201) 681-4957.  We do work out of these counties on occasion.


Please provide us with the following information for contacting you:

* Mandatory fields
+ One of the two must be completed

* Name:
+ Phone:
+ Mobile:
* E-mail:
Send a copy to the email above.


Please provide us with information about your computer:

Computer Type?
Operating System?


Please be as specific as possible when describing the problem.
(example: "Printer doesn't print in Microsoft Word")

What service is this request for?
A brief one-line description of the request:
Detailed description of problem:





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