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Form 1a1

NAME (Student Technician) Grade & Section


1. __________________________________ _____________________________
2. __________________________________ _____________________________

Client’s Name Address Contact No.


1. _____________________________ _______________________ ___________________

PC Type Product/Model No: Current OS Version Installed


Desktop ________________________ _______________________
Laptop ________________________ _______________________

Applications Currently Installed


1. ____________________ 4. _____________________ 7. _______________________
2. ____________________ 5. _____________________ 8. _______________________
3. ____________________ 6. _____________________ 9. _______________________

Current Problems / Issues (details coming from the client)


1. _______________________________________________________
2. _______________________________________________________
3. _______________________________________________________
4. _______________________________________________________
5. _______________________________________________________

Diagnosis (Findings to confirm the current problem or issue)


1. _______________________________________________________
2. _______________________________________________________
3. _______________________________________________________
4. _______________________________________________________
5. _______________________________________________________

Recommendations (action to be conducted by the student technician )


1. ____________________________________________________________________________
2. ____________________________________________________________________________
3. ____________________________________________________________________________

Services Performed
OS Installation/Reformat OS Version: __________________________
OS Upgrade OS Version: __________________________
Driver Installation Source: Online CD/DVD Cracked
Office Installation Office Version: ________________________
Product Registration Mode: Online Cracked

Client’s Satisfaction Rating Suggestions / Recommendations


5 Outstanding __________________________________________________
4 Very Satisfactory __________________________________________________
3 Satisfactory __________________________________________________
2 Fair __________________________________________________
1 Poor __________________________________________________

_________________________
Client’s / Customer’s Signature

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