REQUEST FOR LAPTOP
Please complete and submit this form.
Name
*
First Name
Last Name
Email
*
example@example.com
Is your request for replacing an existing machine?
Yes
No
If yes, what is the existing device (make/model#)?
If yes, is the device still in working order?
Yes
No
What size screen?
12.5"
14.0"
15.6"
Is a Dual Monitor setup currently being used?
Yes
No
Purchase or Rental?
Purchase
Rental
What applications need to be setup?
Is this for a NEW employee?
Yes
No
Server Access
A. Shared Folder Names
B. Mapped Drives
Any connected accessories? (Printers, Scanners, Docking Station, Other?)
Yes
No
If yes, state the accessory types and models below:
Exp. Printer - HP 1700
Is Installation needed?
Yes
No
Is a UPS (Uninterruptible Power Supply) needed?
Yes
No
Any accessories needed?
Docking Station
Carrying Case
Monitor
User information:
a. Name:
b. Email:
c. Number:
d. Location:
User Credentials:
When is the machine needed?
-
Month
-
Day
Year
Date
Is an asset tag needed?
Yes
No
Administrative Rights?
Yes
No
Billing code/charge-back/PO#
Additional Notes/Comments:
Submit
Should be Empty: