Please complete the following form and a Nerd Force representative will contact you to schedule your appointment at a time and place that is convenient to you. Keep in mind, we come to you! If you need immediate assistance, please call 0800 999 NERD.

Name
Address
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Email Address
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How Did You Hear About Nerd Force	Saw Nerd Force Vehicle Received Direct Mail Referral Google Search Yahoo Local Yellowpages.com Qype Other
Equipment Information
Brief Equipment Information
Operating System	Windows XP Professional Windows XP Home Windows Vista Home Windows Vista Business Windows 2003 Server Windows 2000 Windows 98 Windows ME Macintosh OS 9 Macintosh OS X Other
Internet Access	Broadband – Cable Broadband – DSL Broadband – FIOS Broadband - T1 / T2 Dial Up Other
Network	1 Computer / Equipment 2 – 5 Computers / Equipment 5 – 10 Computers / Equipment 10+ Computers / Equipment
Problem Description