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Name:     Phone:  
Company:     Email:  


Will this computer be replacing an existing computer? Yes    No


The peripherals I want:

15" Monitor or Screen
17" Monitor or Screen
19"+ Monitor or Screen
Flat Panel (indicate size, above)
Laser Printer
Inkjet Printer

  Scanner
Speakers
Webcam
Digital Camera
 Other:



The options I want:

Sound/CD Audio
CD Burner
DVD Drive
  Lots of extra memory
Lots of extra disk space
Modem (56k)


 
Quantity:     Budget:  
(both of the above fields are optional)

I will be using this equipment for:

Gaming
Business
  Graphics
Internet


My internet connection is:  


Will this computer be on a network?:  


Please provide any additional details below about your request. Include where and when you would like to have the Computer(s) delivered, and if any cabling will be necessary. If you are looking for a specific internal component or peripheral, please provide those details as well.

 
 
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