Computer Repair Estimate
Please fill out the request form below, or give us a call for an estimate.  We'll be happy
to help.  Please try to fill out all information as accurately as possible.  Thank you.
Contact Information
* Required
Your Name:
* Required
City:
* Required
Zip:
Company:
* Required
E-Mail Address:
Phone Number:
* Required
Alternate Phone Number:
Contact Me By:
Phone
 E-Mail
Computer Information
* Required
Computer Type:
* Required
Operating System:
Please Select from one of the Models Below
Computer Brand:
Please include the Dell Model or
Service Tag Number.
Help?
Dell
Please include the Gateway Model
or Gateway Serial Number.
Help?
Gateway
Please include the Compaq  product
number.
 Help?
Compaq
Please include the HP product
number.
Help?
HP
Please include the IBM product
number and serial number.
Help?
IBM
Please include the Acer Model.
Acer
Please include the eMachine Model.
eMachine
Please include a brief
description of your computer.
Custom Built System
Other
Please give a brief description of the
computer problem:
* Required
Stephens Computer Services
Phone:  256-765-3760
Computer Sales  -  Service & Repair