PLEASE FILL IN ALL INFORMATION REQUESTED BELOW
Contact Name	E-mail Address
Format: First and Last Name
Contact Number	Best Time To Call
Format: 208-555-1212	*** Select A Time *** Morning between 9am - Noon Afternoon between Noon - 6pm Evenings between 6pm and 9pm
Date to call	City
State	Computer Brand
AL - ALABAMA AK - ALASKA AZ - ARIZONA AR - ARKANSAS CA - CALIFORNIA CO - COLORADO CT - CONNECTICUT DE - DELAWAREDE DC - DISTRICT OF COLUMBIA FL - FLORIDA GA - GEORGIA HI - HAWAII ID - IDAHO IL - ILLINOIS IN - INDIANA IA - IOWA KS - KANSAS KY - KENTUCKY LA - LOUISIANA ME - MAINE MD - MARYLAND MA - MASSACHUSETTS MI - MICHIGAN MN - MINNESOTA MS - MISSISSIPPI MO - MISSOURI MT - MONTANA NE - NEBRASKA NV - NEVADA NH - NEW HAMPSHIRE NJ - NEW JERSEY NM - NEW MEXICO NY - NEW YORK NC - NORTH CAROLINA ND - NORTH DAKOTA OH - OHIO OK - OKLAHOMA OR - OREGON PA - PENNSYLVANIA RI - RHODE ISLAND SC - SOUTH CAROLINA SD - SOUTH DAKOTA TN - TENNESSEE TX - TEXAS UT - UTAH VT - VERMONT VA - VIRGINIA WA - WASHINGTON WV - WEST VIRGINIA WI - WISCONSIN WY - WYOMING	*** Select Your Brand *** Compaq Dell E-Machines Gateway HP IBM Other Brand
Operating System	Computer Memory
*** Select Your OS *** Windows 95 Windows 98 Windows NT Windows 2000 Windows XP Home Edition Windows XP Professional Other	*** Please Select Memory Amount *** Below 128KB Between 128KB and 256KB Between 256KB and 512KB 1GB or more Unsure
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