Midway Computer Solutions

Request for more information:

Please fill out the following brief questionaire and we will respond to your request as quickly as possible. The information you provide will be kept strictly confidential and will not be given nor sold to anyone.

1. Name 

2. Address

3. City, State, ZIP

4. Phone      5. Alternate phone

6. E-mail Address

7. How would you like us to contact you? Phone (day) Phone (night) e-mail US Mail
(Please provide contact information above)

8. How did you hear about Midway Computer Solutions?

11. Other questions or comments:

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