Customer Check-in Form

Have you visited us before? Yes No


Please enter your name so that we can grab your previously submitted information.

Your Name:

In order to make your experience as pleasant and as fast as possible, please fill out the following form. We use this information to fill out your receipt, keep track of your purchases and so we know if you've been in before.

First name: Last name:

Your Email Address: 

Phone Number:

City:

State, Territory, or Province:


In order to better serve you please provide as much information as possible. This will help us prepare for your visit.

Primary Purpose of Visit:  

If you are having a computer being repaired, evaluated, or quoted; or if you wish to purchase a computer, fill in its information below. If you are a walk-in customer, please fill this out based on your primary computer you use at home.

Operating System:  

Manufacturer:

Model number:


Where have you heard of us?

Additional Information:


Please ask for the five-digit security code: