TRG Service Request

1
Are you an existing customer of TRG?* This field is required.
YESNO
2
Is this issue related to a system installed by TRG?
YESNO
3
Person Requesting Service* This field is required.
First Name
Last Name
4
Company Name* This field is required.Company, church, organization, or government entity requesting service.
5
Email* This field is required.
example@example.com
6
Phone Number* This field is required.
Area Code
Phone Number
7
Are you the on-site contact for the system?* This field is required.Will you be the person our technician will meet upon arrival to the site?
YESNO
8
Site Contact's Name
First Name
Last Name
9
Site Contact's Phone Number
Area Code
Phone Number
10
Site Contact's Email
example@example.com
11
Address of Service Request* This field is required.
12
Detailed Description of Service Issue* This field is required.Please describe the issues you have been experiencing along with any of the equipment it involves.
Huge
Large
Normal
Small
Ok
Ok
13
Describe any troubleshooting steps taken.* This field is required.Please describe the steps you have taken to attempt to resolve the issue.
Huge
Large
Normal
Small
Ok
Ok
14
Do you have any photos or video of the issue?
YESNO
15
Please upload any photos or video of the issue.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
16
Service AgreementBy submitting this form you agree and understand the terms and service rates.
17
Credit Card Authorization* This field is required.
prevnext( X )
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Service CallThis fee will not be charged until the service call has been completed and invoiced. This is simply a credit card hold to secure your appointment.
$120.00+Edit
Back
Total cost $0.00
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Should be Empty:

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