<b>MAINTENANCE</b> REQUEST
CELLULAR<b>SALES</b> INDIANA
Full Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
E-mail
Store Location
Please Select
BN
BZ
CM
CR
GC
GW
HI
IC
IP
KS
LR
OS
SK
TP
VM
WD
YT
EVENTS
Issue Type:
Please Select
TV'S - REPLACE/REPAIR
INTERNET/FAX/PHONE LINES
COMPUTER - MISSING PARTS/ISSUES
LEAKS - ROOF/WINDOW
CLEANING - CARPET/FLOOR
MARKETING - DISPLAY ISSUES
HVAC - PLUMBING AND HEATING
FIXTURES - BLOWN BULBS/POWER ISSUE
CSOKI RADIO
PAINTING/DRYWALL
DUMMY/LIVE PHONE REPLACEMENT
MISCELLANEOUS
Please enter details and/or description of problem.
If this is a hardware issue, please include the Computer ID.
*
Enter the message as it's shown
*
Number
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