Consumer Aid Request
[ All fields are required... ]


Please enter your full name:                                 Today's date:  

Please describe the problem you've been having, including dates and any names or phone numbers, and email addresses you used or received email from:

Please enter the name, address, email, website and telephone number of the company you are complaining about.

Please enter the date you first contacted that company about this problem:   
Please enter the most recent date you contacted that company about it:     

Please enter what steps you have taken to resolve the problem, and what the results were, or the word "none":

Please provide your email address and confirm it-
   confirm your  

Please provide a phone we can reach you on  days:

Optional:  Please provide your mailing address with this form:

You may email us copies of any letters, emails or other information to support your complaint from the email address you entered above.  Please email the supporting documentation to:

We will investigate your initial submission to determine if it has sufficient information, and will contact you back if we can.  Not every submission can be replied to.  Nonetheless, we shall endeavor to do so.

Please note: we believe we can help many consumers with an unresolved problem.  By pressing the Submit button below, you agree to fully indemnify and hold harmless the American Computer Science Association Inc. ("ACSA") and it's employees, volunteers, agents and representatives from any consequences of requesting aid and assistance with your problem and for any acts taken by ACSA and it's employees, volunteers, agents and representatives related thereto .  There can be no guaranty nor warranty that such aid will help you with your problem.  This form and it's use are subject to general business law of the State of New Jersey.  ACSA is a non-profit foundation organized under IRC 501(c)3.




Copyright 2005 ACSA Consumer Concerns