First Name:  * Last Name:  * Phone Number:  * Email Address Optional: Address:  * Cross Street:  * City:  * State:  * Zip Code:  * If you are setting up multiple appliances please come back to this page and check if this is 2nd or third appliance etc. and fill out the model number and information: (1st) appliance (2nd) appliance (3rd) appliance (4th) appliance (5th) appliance Brand of Appliance:  * Type of appliance:  * Model Number:  * Serial Number (not required for out of warranty calls) Trouble reported: Please check the box for type of service Manufactures warranty Non manufactures warranty Service contract C.O.D Will pay for service Purchase date (only required for warranty calls) Where did you buy it from? Badcock Famous Tate Best Buy Aarons Lowes Home Depot Ebay Internet Other When is the best time for service? Morning 8-12pm Afternoon 12-5pm Anytime 8-5pm First call 8-9am Last call of day 3-5pm Before 3pm Please note: We do call a day before service is ran. Also a notification phone call will be done when the tech is acutally on the way to your home. After you submit the form a representive from Cannon's Appliance Service will call you to schedule the soonest appointment date. Security code:   * Do not enter anything in this field: