Elite Printer Services

Tech Form

Fill out as best - or please be as detailed as possible

Technician Details:

First Name:

Last Name:

Address:

City:

State:

Zip:

Country:

Primary POC:

Secondary POC:

Web Site URL:

Normal Work Hours: To:
Normal Work Days: Mon Tue Wed Thu Fri Sat Sun

After Hours Available: Yes No

How did you hear about Elite Printer Services, INC.:

Primary Phone:

Secondary Phone:

Fax:

Email:

SSN/Federal Tax #:

# of Field Techs:

Dunn & Bradstreet #:

Areas Of Coverage: - enter your local ZIP code and indicate the distance you are willing to travel from that location.

Willing to travel: 10mi 25mi 50mi 100mi

Are you a member of any other local, regional or national service network? Yes No

Please select all certifications/skills currently held:

3COM

3Com Certified Solutions Associate
3Com Certified Solutions Expert
3Com Network Certified

LABOR

General Laborer

LAPTOP

Apple Laptop Ceritified Engineer
Tech has a Torx Screwdriver
Toshiba AWT Certified
Toshiba Knowledgeable
Toshiba TAT Certified
Toshiba TCE Certified
Toshiba TCT Certified

POS

Tech works on POS (Point of Sale)

Other Skills (Explain):

Tech Form

Fill out as best - or please be as detailed as possible

Technician Details:

3COM

DESKTOP

LABOR

LAPTOP

OTHER

POS

PRINTER

ROUTER

SERVER