Open Door Technology Request Form
Employee
First Name
Last Name
Date of Request
-
Month
-
Day
Year
Date
Position Title
Dept location:
Park West
SCL
CAC
Corporate
UCO
Open Door Art Studio
Workspace/office location
Reason for request
New Employee
Transfer to new position
New duties requiring technology
If applicable, who is the employee replacing?
Needs Open Door company email? (set up Domain login and Profile folder)
Yes
No
IT/tech Equipment Requested:
Desktop
Laptop
Tablet
Open Door Cell phone
Phone stipend
Open Door Desk phone
Mouse
Keyboard
Monitor
iPad/iPhone Cord
IPad/iPhone Cube
Other
Software requested: (NOTE: All are loaded with Microsoft Office products)
Advisor
Great Plains
Adobe Acrobat
Adobe Creative Cloud
Timeforce
Caretracker
Connect a Voice application and invite
Other
Name of person submitting request
First Name
Last Name
Email of person submitting request
example@example.com
Submit
Should be Empty: