Remote Computer Service Subscription
Dear Customer,

Through this year I am taking on two new customers each month.
Please fill out the customer contact information below.
I will email/text you a link to begin your subscription.

When you subscribe I will schedule a one-time home visit to meet you and set up remote access software on your computers. We can discuss your technology needs and make sure you have my contact info ready when you need me.

Thank you for choosing me to provide your computer services.

Sincerely,
Dan Gildea
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Street Address *
City *
State *
Zip *
Cell Number (for texting only)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ScaryHouse.com.

Does this form look suspicious? Report