Tech Support Request Form
Type of Request
*
Tech Request
Customer Onboarding
Account Rep Email
*
Please type the sales rep email (will receive a copy of the form)
Implementation Rep Email
*
Type the business representative email (will receive a copy of the form)
Authorized Organization User / Admin
*
First Name
Last Name
Authorized Organization User Email
*
example@example.com
Accounts Payable Name
*
Michael Scott
Accounts Payable Contact
*
example@example.com
Is The User Above Already On The Platform?
*
Yes
No
I Don't Know
Name of the Organization/District
*
This will be the name of the organization on STEAM On Demand & should match the organization/district name in Salesforce
Name of the School
*
This should match the school name in Salesforce
Organization or School Website Link
*
URL only
Salesforce Opportunity Link
*
Add a direct link to the opportunity. This is important for implementation.
Membership Type
*
Monthly - If Monthly, user must be sent the onboarding form & pay with a CC
Annual
Subscription Tier
*
Please Select
Single Classroom
STEAM Teacher
Subscription Type(s)
*
Please Select
STEAM Only
Coding Only
STEAM & Coding
Subscription Start Date (Date of Access)
*
/
Month
/
Day
Year
Date
Subscription End Date (End of Subscription - Req for Annual)
*
/
Month
/
Day
Year
Date
Total Number of User Accounts (Including Admin)
*
Used to help prepare for training
Number of Teachers at Organization
*
Number of students the account has, regardless of how many are using the platform. Can be used for renewals and sales
Anticipated Number of Students
*
Number of students the account is planning to use the platform for
Price Quoted
*
Specify the price amount above
Payment Method
*
Purchase Order
Website (Credit Card Sign Up)
Direct Invoice (not a PO)
Stripe Link
Other
Purchasing Kits?
*
Yes - If yes, must add the mailing address below
No
Unsure (Add Notes Below)
Kit Mailing Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
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
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Customer Additional Details & Requests
*
Add information on customized sales packages, customer requests, any details helpful for implementation & ongoing support
Name
*
First Name
Last Name
Email
*
example@example.com
Nature of Request
*
Technical Support
New Feature Request
Bug Fixing
Performance Optimization
Content Update Suggestion
Other (Please specify):
Urgency
*
Low
Medium
High
Critical
Desired Completion Date
*
/
Month
/
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Topic
*
Please Select
STEAM On Demand
STEAM Depot
IDEA Lab Kids Website
GSuite (Email, Drive, etc)
Discord
Salesforce
Data Request
Trackable Link
Nolej Output Link
Sub Topic (SOD)
Please Select
Resources Accordion Items
Interactive Video Elements
Membership Access and Subscriptions
Issue not listed above
Target Page
Please Select
Home Page
Demo Page
Contact Page
Pricing Page
Free Trial Page
Lesson Page
Choose one of the pages to automatically fill the URL field below
URL
*
This is the link to the landing page or targeted page (eg: https://steamondemand.org/pricing)
Campaign Name
*
This is the name of the campaign (eg: Campaign-48) P.S. use dashes instead of spaces (no colons, semicolons, periods, &, $, % or any other special characters)
Subject
*
This is the subject line (eg: ) P.S. use dashes instead of spaces (no colons, semicolons, periods, &, $, % or any other special characters)
Result
Copy the text above to use in your embed
Subject
*
Please describe the request briefly here
Description
*
Please provide a detailed description of your request or the issue you're facing. Include any relevant context, error messages, and steps taken so far. For subscriptions please include the users email or school email domain. For any Nolej related-content, be sure to be really specific with the feedback and share related links. Submit a ticket for each lesson if you have feedback on multiple lessons.
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