SCHEDULE AN
APPOINTMENT WITH US
ON-LINE OR IN PERSON
THIS FORM ALLOWS OUR POTENTIAL
CLIENTS TO BOOK AN APPOINTMENT VIA E-MAIL
1. NAME:
2. YOUR COMPLETE MAILING
ADDRESS:
3. YOUR TELEPHONE
NUMBER
4. YOUR ICQ NUMBER.
(This program is available free of charge and can be
downloaded from http://www.icq.com.
It allows you to talk to us via text chat. Our ICQ number is
11864137)
You may enter your ICQ
number below if you would like to contact us by ICQ.
We strongly recommend
that you obtain ICQ program in advance and test their
reliability before arranging an appointment with us. If the
Internet traffic is extremely busy you may experience some
difficulties with transmissions unless you have at least
(28,800 kpbs modem 64 Megs of RAM and 200 MHz processor).
5. YOUR IRC NAME
(Alias). If you have a 586 computer or older you may want to
have your appointment with us using irc (text chat line). This
software is available from http://www.mirc.com
. We have our own corporate channel #CDCI on Dal net. If you
decided to use this method of communication please enter your
"NICK NAME" (or ALIAS) by which you can be
recognized. We suggest that you use either your first or last
name so we can recognize you on our channel. You may enter
your "NICK NAME" or (ALIAS) in the box below.
AND NOW PLEASE LET US
KNOW YOUR PREFERRED WAY OF MEETING WITH US.
I would like to attend
my appointment by: (please select one or more appointment
options by holding CTRL key and clicking with your mouse).
6. HAVE YOU USED ANY OF
OUR SERVICES BEFORE?
If yes, when (please
specify):
7. TIME OF YOUR
APPOINTMENT
Hour Minute
Month DAY Year
8. TYPE OF YOUR
APPOINTMENT: (you can select one or more appointment options
by holding CTRL key and clicking with your mouse).
Please enter any
information related to your appointment along with any
relevant details:
PRIORITY OF YOUR
APPOINTMENT
NON-EMERGENCY. WHENEVER POSSIBLE
EMERGENCY. AS SOON AS POSSIBLE
9. PLEASE ADD ANY
ADDITIONAL INFORMATION REGARDING YOUR APPOINTMENT IN THE BOX
BELOW:
HOW WOULD YOU LIKE TO
RECEIVE OUR CONFIRMATION? (i.e. e-mail, fax, telephone call,
icq message) Please indicate your preference below:
Thank
you for your interest in our services. We look forward to
our meeting.
.