WJS Enterprises Online Service Call Form

<body link="#0000FF" vlink="#0000FF" alink="#FF0000"> <table border="0" cellpadding="0" cellspacing="0" width="600" height="100%"> <tr> <td valign="top" width="100" bgcolor="#33CCFF" height="100%" align="center"> <div align="center"> <center> <table border="0" cellpadding="2" cellspacing="0" width="100" style="font-family: Arial; font-size: 8pt; text-transform: uppercase; font-weight: bold; color: #0000FF; text-align: Center" align="left"> <tr> <td width="100" height="100%" align="center"> <p align="center"><span style="text-transform: uppercase"><a href="html/meter_readings.htm"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><br> ENTER METER READING</b></font></a></span></td> </tr> <tr> <td width="100" height="100%" align="center"> <p align="center"><span style="text-transform: uppercase"><a href="html/service_awards.htm"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><br> AWARD WINNING SERVICE</b></font></a></span></td> </tr> <tr> <td width="100" height="100%" align="center"> <p align="center"><span style="text-transform: uppercase"><a href="html/service_call.htm"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><br> PLACE A SERVICE CALL ONLINE</b></font></a></span></td> </tr> <tr> <td width="100" height="100%" align="center"> <p align="center"><span style="text-transform: uppercase"><a href="html/service_info.htm"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><b><br> SERVICE INFORMATION REQUEST</b></font></a></span></td> </tr> </table> </center> </div> </td> <td valign="top" width="500" bgcolor="#FFFFFF" height="100%" align="center"> <h3 align="center"><font color="#0000FF" size="5" face="Times New Roman, Times, Palatino, serif"><b><br> WJS Online Service Call Dispatch Form</b></font></h3> <p align="center"><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Use this form to place a Service call on your equipment with use online.</font></p> <hr width="80%" size="4" color="#0000FF"> <p align="center"><b><font face="Verdana, Arial, Helvetica, sans-serif" size="3">Contact Information</font></b></p> <form method="POST" action="_vti_bin/shtml.exe/ServiceCallHomePage.htm" onSubmit="" name="Online Service Call Report" webbot-action="--WEBBOT-SELF--"> <input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"> <div align="left"> <table border="0" cellpadding="2" cellspacing="4" width="100%"> <tr> <td width="29%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Email Address</b></font></td> <td width="71%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><input type="text" name="email" size="35"></font></td> </tr> <tr> <td width="29%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Company </b></font></td> <td width="71%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><input type="text" name="company" size="35"></font></td> </tr> <tr> <td width="29%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Contact</b></font></td> <td width="71%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><input type="text" name="contact" size="35"></font></td> </tr> <tr> <td width="29%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Phone Number</b></font></td> <td width="71%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><input type="text" name="phone" size="20"></font></td> </tr> <tr> <td width="29%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Fax Number</b></font></td> <td width="71%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><input type="text" name="fax" size="20"></font></td> </tr> </table> </div> <p><b><font face="Verdana, Arial, Helvetica, sans-serif" size="3">Equipment Information</font></b></p> <div align="left"> <table border="0" cellpadding="2" cellspacing="4" width="100%"> <tr> <td width="35%"><b><font face="Verdana, Arial, Helvetica, sans-serif" size="2">WJS Equipment ID </font></b></td> <td width="65%"><input type="text" name="Equipment_ID_1" size="20"></td> </tr> <tr> <td width="35%"><b><font face="Verdana, Arial, Helvetica, sans-serif" size="2">Model Number<br> </font></b><font face="Verdana, Arial, Helvetica, sans-serif" size="1">(Necessary if you don't have WJS ID)</font></td> <td width="65%"><input type="text" name="meter_reading_1" size="20"> </td> </tr> <tr> <td width="35%"><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Serial Number<br> </b></font><font face="Verdana, Arial, Helvetica, sans-serif" size="1">(Necessary if you don't have WJS ID)</font></td> <td width="65%"><input type="text" name="meter_reading_date_1" size="20"></td> </tr> </table> </div> <p><font face="Verdana, Arial, Helvetica, sans-serif" size="2"><b>Type any additional information about the equipment's<br> problem in the area below.</b><br> <br> <textarea rows="10" name="information" cols="50"></textarea><br> <br> <b>Enter your Service Call by depressing the "Submit" button. <br> The "Reset" button will clear all the forms fields</b></font></p> <p align="center"><input type="submit" value="Submit" name="B1">          <input type="reset" value="Reset" name="B2"></p> </form> <p> </p>  </td> </tr> </table> <p align="center"><font face="Verdana, Arial, Helvetica, sans-serif" size="1"><span style="text-transform: uppercase">| <a href="index.html" target="_top">HOME</a>  |  <a href="html/AboutUS_Home.htm" target="_top">ABOUT US</a>  |  <a href="html/Product_home.htm" target="_top">PRODUCTS</a>  |  <a href="html/Supply_home.htm" target="_top">SUPPLIES</a>  |  <a href="html/Service_home.htm" target="_top">SERVICE</a>  |  <a href="html/Featured_home.htm" target="_top">FEATURED</a>  |  <a href="html/Employment_home.htm" target="_top">CAREERS</a>  |  <a href="html/News_home.htm" target="_top">NEWS</a> |</span><a href="mailto:webmaster@wjsenterprises.com"><br> </a><br> This Page Last Revised on : September 29, 2003 <br> Copyright © 2001 [WJS Enterprises, Inc.]. All rights reserved.<br> For Questions and Comments about this Web Site email <a href="mailto:webinfo@wjsenterprises.com" target="_blank">webinfo@wjsenterprises.com</a></font> </body>