Note:  Due to the fact that our Host Server does not support Front Page extensions,
                    we are currently limited to handling this form data via email.  

                    Although this is normally not a problem, it does put your personal contact
                    information at risk of interception.  If this is a problem, do not continue.
                    Instead, call Riel Technical Support at 603 796-2874.

          Please provide the following contact information:
          (Red highlights indicate required information)

First Name:
Last Name:
Middle Initial:
Title:
Organization:
Street Address:
Address (cont.):
City:
State:
Zip Code:
Work Phone:
Home Phone:
FAX:
E-mail:
URL:

          Choose one of the following category options:

Request for Service Request for Estimate

          Enter a preferred date for the Service to be done:
          (Not guaranteed, but we will do our best to accommodate it.)

-- mm/dd/yy

          Enter a preferred time for the Service to be done:
          (Not guaranteed, but we will do our best to accommodate it.)

-- hh:mm am/pm

          Select any of the following service options that apply:

PC Repair	PC Upgrade	PC Install 	PC Training         
Software Repair	Software Upgrade	Software Install 	Software Training
Network Repair   	Network Upgrade	Network Install	Network Training
Web Site Repair	Web Site Upgrade	Web Site Authoring	Web Site Training
Data Recovery	External PC Add-On	Web Site Promotion

         Enter any other applicable service options not listed above.

  -- other #1

  -- other #2

          Are you providing any of the hardware or software needed for this service?
          (i.e.: Any products that you have already purchased, or will be purchasing.)
          If Yes, please provide the details in the 'Details Box' below.

Yes No

          Does Riel Technical Support need to provide any specific hardware or software
          to complete this service?
          If Yes, please provide the details in the 'Details Box' below.

Yes No

          Do you wish for Riel Technical Support to provide ALL hardware and software
          needed to complete this service?

Yes No

          Enter your computer make (i.e.: Dell) in the space provided below, if you know it.

          Enter the Details of the service that you would like performed,
          or as many Details of your problem as you can provide.

          Would you like us to call you for more detailed information?

Yes No

          Note:  Due to the fact that our Host Server does not support Front Page extensions,
                    we are currently limited to handling this form data via email.  

                    Although this is normally not a problem, it does put your personal contact
                    information at risk of interception.  If this is a problem, do not continue.
                    Instead, call Riel Technical Support at 603 796-2874.
                    
                    We apologize for this temporary inconvenience.

                    If this is not a problem to you, then hit the Submit Form button
                    and then answer OK to the security warning that you may receive.

                    In order to complete your posting of this Service Request, you need to open
                    your default email software so that it can 'Send' the posting that you just
                    created with this form.  If your email is set up to automatically send outgoing
                    mail, then it will happen on it's own.  If not, then you will need to locate the
                    posting that should be found in your 'Out Box' and manually send it.

                    Again, we apologize for this temporary inconvenience.