Workstation Request Form

Requester's Information
Company Name *
Requester's Name *

First Name Last Name
Best Contact Number *

Area Code Phone Number
E-mail *
Preferred Delivery Date *

Month Day Year
We will try to accommodate the requested delivery date, however; our delivery date is based upon the time the hardware is received in our office. Once our bench has received all hardware please allow 2 to 3 business for our dispatcher to contact you to schedule an on-site. If you have any questions or concerns regarding this delivery date, please get with your account manager.

User Information
This request is for which type of account *
New Employee's Name *

First Name Last Name
E-mail Address *
Office Location/Site *
New User Start Date

Month Day Year
Date
If new employee, please name which existing employee you would like us to mirror *

First Name Last Name
Current Employee's Name *

First Name Last Name
E-mail Address *
Office Location/Site *
Do we have permission to change this employee's profile password to i.t.NOW's default password? *
If no, please include employee password

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Acknowledgment