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Job/Work Request Form.
In emergencies please contact us at (0755517908/0714220334) or
dtechcoms@gmail.com
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* Indicates required question
Email
*
Your email
Full Names
*
Your answer
Location( Indicate your business area)
Contact/Phone number
*
Your answer
Is your problem a Service or Products request?
Service request
Product request
Other:
Email address
*
Your answer
Describe the problem
Location of problem
*
Your answer
Describe the kind of service or product you want me to offer you or attend to.
*
Option 1
Other:
Priority
*
Very high
1
2
3
4
5
Very low
Due date
MM
/
DD
/
YYYY
More details
Your answer
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