JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Solicitud de Assistencia Remota
*Cuando se envíe este formulario, recibirá un correo electrónico con instrucciones en un plazo de 24-48 horas.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Nombre
*
Your answer
Correo Electronico
*
Your answer
Direccion de casa
*
Your answer
Numero Telephonico
*
Your answer
Tiene su computadora acceso al Internet?
Sí
No
Clear selection
¿Que problema tiene su computadora?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
