Company

First Name*

Middle Name

Last Name*

Phone*

Email

Cell

Fax

WeChat ID

Preferred Contact

Brand

Model

Computer Type*NotebookDesktopTablet2-in-1

Operating System*WindowsChromeOSAndroidMacOS/IOSDualOS

Dropped OffPower CordBagCDUSB

Can get into OS?yesno

Previous DamageWater DamagePower FailurePhysical Damage

Country Purchased fromUSAChina

Is PC Yours?* yesno

Have Username and Password? (Give info when walk-in) yesno

New Computer Services: Set up users, and Install 3 software/browsers.

Transfer files from the old computer to the new computer

Install Printer Driver.

Install an all-in-one scanner Copier Printer.

Windows Service

Install Windowsyesno

Windows 10Windows 8Windows 7

Repair Windowsyesno

Windows 10Windows 8Windows 7

Upgrade Windowsyesno

from Windows 8from Windows 7

File Backup (Before Service) yesno

Change System Languageyesno

Remove Virus yesno

Remove Password yesno

File Backup

Windows is Working (without open PC)Windows Not Working (Need Open Case)

Blue ScreenBlack Screen

File Recovery

From Computer Hard Drive (Need Open Case)From External Hard Drive

I Bought Hard DriveNo, I did not bring (Add Estimate Fee for Most Models. If cost more, please pay difference when pickup)

Hard Drive Size (Price may vary by market price)

500 GB1 TB2 TB3 TB

1. State problems or work needed to be done, if you didn't see service item above. (required)

2. Any new software/hardware needs for installation/replacement?

Additional Information

Terms & Conditions

1. The new hardware (such as hard drive, power supply, cpu fan) has 1 year warranty. New display screen, notebook keyboard have 1-3 month warranty (depending on vendor) . Service has a 7-day warranty.

2. GCI is not responsible for OS failure due to unstable hardware.

3. If the customer decides not to replace broken part(s) or repair the PC after GCI diagnoses the PC, GCI will only charge a diagnosis fee.

4. The customer should provide correct information.

5. GCI will keep devices up to 1 month. If customer doesn’t pick it up, GCI has the right to dispose of or recycle the device.

6. Service fees are non-refundable.

7. **Above fees are for services. Software & Windows license fee are separately.

I Agree: I acknowledge all the information I provided above is correct. I authorize GCI to work on my PC & agree to Terms of Service.

Requested by (Type Full Name* - required)

Date Requested