NAME_______________________

EMAIL_________________________
 
ADDRESS__________________________

CITY_______________________

ZIP___________

CONTACT NUMBER(___)_________________

ALTERNATE(___)__________________




WHAT IS THE MAKE AND MODEL OF YOUR PHONE?________________________






DESCRIBE PROBLEM WITH PHONE______________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________


DO YOU NEED A RUSH REPAIR? Same Day $25 _____  2 Day $15____ extra.


METHOD OF PAYMENT: 


We will call you when we receive your phone,and evaluate its condition.
If you wish to speed up the process, fill in the credit card info


(TYPE OF CREDIT CARD)________Number_______________Exp Date_________



Ship your phone Securely to the address below.


CELL PHONE REPAIR
18873 US Highway 19 N
Clearwater, FL 33764-3122
727-573-2355




Thank you and God Bless