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| Your
Name |
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| E-mail |
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| Phone |
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| City |
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| School
or Center |
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Who is your ETL Representative? |
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Which software application do you need assistance with? |
Software Application:
Version Number:
(example: "42.1") |
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Select your computer type. |
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Where does the problem occur?
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Lesson Number:
Program:
Examples: "Tick-Talk", "Listen-Write" |
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If there is an error message displayed, please type it here. |
Example: "Runtime error 5 Invalid procedure call" |
| Additional description:
(What key was pressed, what is on the screen, etc.) |
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| Please enter the verification code
displayed, then click Submit. |

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