Electronics Repair Form

    Your Name (required)

    Your Email (required)

    Telephone (required)

    Street Address

    City, State Zip

    Where did you hear about us? (required)

    If Other:

    Drop-off date/time requested (required)

    Drop-off location requested (required)

    --- Equipment Information ---

    Equipment 1

    Make 1

    Model 1

    Serial 1

    Short description of problem 1:

    Equipment 2

    Make 2

    Model 2

    Serial 2

    Short description of problem 2:

    Equipment 3

    Make 3

    Model 3

    Serial 3

    Short description of problem 3:

    I have read and accept the Terms and Conditions

    A deposit fee of $60.00 is paid upon dropping off equipment. The final repair bill will deduct the deposit fee.

    We accept Cash, Check, or CashApp

    You can pay the deposit in advance here: CashApp


    Enter Security Code

    Simple Math Question