New Hire Request
Please fill out and specify needs for new hardware
Name of User
*
First Name
Last Name
Planned Start Date
*
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Month
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Day
Year
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Name of Requester
*
E-mail of Requester
*
Phone Number / ext
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Area Code
Phone Number
Department
*
Length of Employment
*
Please Select
0-3 Months
4-6 Months
7-12 Months
Intern
TBD
Type of Computer
*
Please Select
New Desktop
New Laptop
Re-purposed Desktop
Re-purposed Laptop
Tablet
Choose Software to Install
*
Microsoft Office
Adobe Acrobat
Syteline
Lotus Notes
Doc Aces
Google Chrome
Peripherals Needed (Select all that Apply)
Wireless Mouse/Keyboard
Printer
Scanner
2nd Monitor
iPhone
Other Software
Additional Requirements
Administrative Rights
Remote Capabilities
Travelling User?
Notes on Mobile Device?
Mapped Drives / Printers Required:
*
Additional Information
Date Submitted
*
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Month
-
Day
Year
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Date Requested By
*
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Month
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Day
Year
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Submit
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