Sign Up
Products
Resources
About TDC
FAQs
Blog
Contact
Log In
Tech Device Coverage Application
Please fill out the form below to apply for a high volume policy with TDC.
Contact Details
Company Name
First Name
Last Name
Phone
Email
Address
City
State
Please Choose
Alaska
Alabama
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Device Information
Device(s) - separate by comma
Model(s) - separate by comma
How many devices?
Age of devices?
Years
Months
Screen repair cost
Replacement device cost
Touch Screen?
Please Choose
Yes
No
Unknown
Protective Cases?
Please Choose
Yes
No
Unknown
Any repairs completed? - explain
Current Repair Solution
Additional Details
How you heard about TDC?
Please Choose
School Device Coverage
Google
Referred by Friend
Email
Trade Show
Unknown
Other
Referred by
Comments
Submit
Back to Top