Player's Choice
Attn: Console Repair Department
2539 Lewisville Clemmons Road
Clemmons, NC 27012


Player's Choice CONSOLE REPAIR / MODIFICATION FORM:

Print this form out, fill it in and send it with your game console. To the above address
Please "Print" information clearly.
Also, please do not send cords, controllers, etc to us.  We only need your console.

 
NAME: __________________________________________________________
ADDRESS: __________________________________________________________
CITY: __________________________________________________________
STATE: __________________________________________________________
ZIP: ____________________
EMAIL: __________________________________________________________
HOME PHONE: ________   __________________________
WORK PHONE: ________   __________________________

 
Please Explain What is Wrong with your System (Bad Controller Ports / Want Read Game / Want Power Up / Etc.)

 
 
 
 
 
 
 
 
 

 

 
Please Circle Your Repair Request
Sony Playstation Repair: $39.99 + $10.00 Shipping Includes parts, labor,  USPS  Ground shipping.
Playstation 2 Repair: $59.99 + $10.00 Shipping Includes parts, labor,  USPS  Ground shipping.
Sega Dreamcast Repair: $49.99 + $10.00 Shipping Includes parts, labor,  USPS  Ground shipping.
Nintendo 64 Repair:  $39.99 + $10.00 Shipping Includes parts, labor,  USPS  Ground shipping.
NES Repair:  $19.99 + $10.00 Shipping Includes parts, labor,  USPS  Ground shipping.
Game & Disc Repair: $3.99 + $6.00 Shipping Includes parts, labor, USPS Ground Shipping.

 
 
 
PAYMENT METHOD:                 Money Order      Personal Check      Paypal.com       Visa       Mastercard     Discover
 

Credit Card Number:   _________    _________    __________    __________      exp______/______

 
 
Payal:  Please send any payments via paypal to bweaver@wholesalebinocular.com

Money Order / Personal Check:  Please make the check out to Player's Choice