Full Name:
REAL Email Address:
Do NOT use a fake email here.
Our service provides discounts for members of particular groups or "companies". What is your member number?
How long have you had your computer?
What brand and model is your computer? (This can usually be found on stickers or engravings in or on the case.)
Which Windows Operating System(s) are you using and need assistance with?
Windows 2000
Windows XP SP 1 or 2
I don't know
What speed is your processor?
How much RAM or memory does the computer have? ex.-128MB, 256MB, 512MB
How much hard drive space does your computer have? ex.- 20GB, 40GB, 80GB, 120GB ALSO, How much of that space is free?
What type of problems are you experiencing? Include the names of programs you use that are affected.
When you start your computer, how long do you estimate it takes?
What virus scanner do you use? If none, type N/A
Have you had any viruses that you couldn't remove from the computer in the last 3 months?
Yes
No
I don't know.
My virus scanner has not warned me about any.
Do you already have spy/mal/ad-ware protection and or tools?
Yes
No
I don't know.
Which Internet Service are you a subscriber of?
Dial-up
ISDN
DSL
Cable
Satellite Dish
T1
T3
I don't know
Who is your Internet Service Provider?
ex. - AOL, Mediacom, Qwest
Open a web-page browser, time it, how long does it take? ex.- Internet Explorer or Firefox
What do you use your computer for?
Check all that apply.
Just browsing the internet, and checking my email.
Business or Network Marketing.
Personal Banking or Financial Record keeping.
Online Gaming.
Managing Web-sites and Materials.
Media Management such as Movies or Music.
Photo or Video Editing.
I don't use it, it's a heap of junk.
Other: You didn't list it in the options!
If the answer to above question is other, please state the nature of use.
Your phone number.
Would you be willing to write a testimonial about my service if you qualify and receive it?
Yes
No
Maybe
Terms and Conditions
By submission of this form, you whole-heartedly agree to qualify for
service from remotetechsupportonline.com. Any information gathered from
or used by remotetechsupportonline.com to provide you with service is
forever deemed confidential by all parties. Therefore, legal action
cannot be taken by either party if an unexpected disaster occurs. In
absolutely no way is remotetechsupportonline.com responsible for loss
of data or corruption of important files stored on your PC. We cannot
recover lost or corrupt files! Any information passed between any party
is strictly for the use of remotetechsupportonline.com to better service
your needs as a customer. In absolutely no way will remotetechsupportonline.com
use any of the information provided by you, by admission or by accident
in any illegal manner. Please click the "Submit Form" button
below to agree to these terms and conditions.