Item Check-in (One Item Per Sheet)
Sunday, September 13, 2020 - Virtual Repair Cafe - This event will be held remotely.  Fixers will work to guide customers to fix their own items.  Please complete this form by end of day Wednesday, Sept 2nd to allow for coordination of logistics.  At this time we will probably only repair one item per customer, but you may submit multiple and indicate priority in case there is time.

***For your safety, we will not engage in any repair action that exposes the user to line voltage (bare or exposed wires or terminals that can be connected to an electrical outlet). ***
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Name *
Email Address *
Phone Number *
Since fixing remotely puts more demands on our 'customers' than fixing in person, we would like to know how much repair experience do you have?
Clear selection
We may need to coordinate real time with you to manage logistics. Can we send text messages to this phone number? *
Do you have access to a smart phone or computer/laptop with a web cam to show your fixer your broken item via video call? *
Which of the following video call/conferencing apps are you able to use *
Required
Item *
Problem Description: be as descriptive as possible (does it turn on?  work sometimes? only in certain functions? was it dropped, submersed in water etc?) *
Manufacturer:
Model/Serial Number
Year of purchase (approx)
What if anything has been tried in an effort to repair this item? *
Initial here to acknowledge that you understand that customers repairing their own items do so at their own risk.  Neither the organizers of the Repair Café nor the repair volunteers are liable for any loss that may result from advice or instructions concerning repairs, for consequential loss or for any other kind of loss resulting from work performed via the Virtual Repair Café. *
What are your top 3 preferred half-hour time slots between 11 am and 3 pm?  We will try our best to accommodate you.  First choice time slot: *
Second choice time slot: *
Third choice time slot: *
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