Technical Support Form
Name:
E-mail:
Phone #:
Course Name:
Type of Computer:
PC
Mac
Location:
Home
Work
Other
Internet browser:
(e.g. Internet Explorer, Netscape)
(Please include version)
Internet Connection:
Choose a connection
56K Modem (Dial-up)
ISDN
DSL
Cable Modem
T1
T3 or greater
Other
If other, please specify:
Date of error :
Time of error :
Which part of the course web site were you trying to access?
Please be specific.
Was there an error message? If not, what seems to be the problem?
Please be specific.
How have you tried to fix the problem?
Have you changed anything on your computer recently?
No
Yes
If so, please explain:
