Ultimate PC Repair Order Form

 

Use this order form to print out and send in.
Please Make Check Payable To:Otis F. Cooper

 

YOUR NAME:            ________________________________
ADDRESS:                  ________________________________
ADDRESS LINE 2:     ________________________________
CITY: ____________________ STATE:_______ ZIP:_______

PHONE #: (____)_____________________________________
E-MAIL ADDRESS: __________________________________

OPERATING SYSTEM:WINDOWS

3.1_____WIN95____WIN98____WIN2000_____

MAKE AND MODEL OF
PC:______________________________________

MAKE AND MODEL OF
MONITOR:________________________________

MAKE AND MODEL OF
PRINTER:_________________________________

PROGRAM(S) ORDERED:
PC REPAIR,CDROMS $29.95_______ PC REPAIR,VHS $29.95_______
PC MOTHERBOARDS $12.95_______PC TEST $17.50______
PC PERIPHERALS $12.95______ SYSTEM UNIT $12.95____
PC REPAIR 5.0 SUPER PACK $99.95________PC DRIVES $12.95_____
PC SUPER PACK SUPER BOWL SPECIAL $62.95________

NOTHING BUT TROUBLE $12.95 PC REPAIR 3 DVDS$39.95_____
PC REPAIR 5 DVDS $49.95______