Fill Us In                             Step 1 of 2


This is a way of quickly contacting us about helping you with ...

Your COMPUTER.  Your NETWORK.  Your INTERNET.  Or in case of emergency.

Please provide the following information:

Click the items we need to help you with ...

[NOTE: in this scrolling list, you can click more than one item by holding down the control key when you click your selections. Keep holding the control key down until you have made all your selections. Then click outside the scrolling list box and proceed to the next section. Optionally, you can click a range of items in the scrolling list by holding down the shift key while clicking the first item and then the last item.  Optionally, you can mix the control key and shift key clicks.] 

[Bonus -- this method works in many places on your computer.]

Choose one of the following options you wish to use for our primary means of contact.

EMAIL
ONLINE
TELEPHONE
US MAIL
Undecided


 

Please provide your relevant contact information:

*              Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
*             E-mail
URL

We accept the following to pay for our services.

  •  MasterCard
  •  Visa
  •  Discover
  •  American Express
  •  PayPal
  •  Money Order
  •  Cashiers Check


At this point you are probably done with Step 1.  You might want to review it. Go over it once, just to make sure. After you click the Submit button below, you will proceed to Step 2 and complete your payment.. 

Based on your information, we will contact you with regard to how we will help you out.  Now click the Submit button below.

 


This form is not shared with anyone besides us and the information exchanged is considered confidential between us.
Copyright © 2005 connectthem. All rights reserved.
Revised: 10/21/06
 Copyright © 2006 connectthem    All rights reserved.

connectthem is a trademark of connectthem
  All other trademarks and brands are are the property of their respective owners.
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