New Hire Technology Request
Your Name
First Name
Last Name
Your UA NetID
Your Email
example@example.com
Your Phone
-
Area Code
Phone Number
New Hire Name
First Name
Last Name
New Hire NetID
New Hire Title
Start Date
-
Month
-
Day
Year
Date
Office Location
Reports To
First Name
Last Name
FTE
> .5
< .5
Laptop or Desktop
Laptop
Desktop
Mac or PC
Mac
PC
(Dual monitors not available for Mac)
Monitor Choice PC
Single 24"
Double 24"
Single 27"
None, they already have a monitor
None, they do not need a monitor
Monitor Choice Mac
Single 24"
Single 27"
Dual monitors not available for Mac
None, they already have a monitor
None, they do not need a monitor
Monitor Choice
Single 24"
Double 24"
Single 27"
None, they already have a monitor
None, they do not need a monitor
Additional Equipment Needed
Headset
Webcam
Is the new equipment grant funded?
Yes
No
Grant Account Number
Division
BHS
CSHS
GNHE
N/A
Program/Office - Select all that apply
BSN
BSN-IH
MEPN
DNP
PhD
OSAA
Clinical
Business Office
LHTI
ORS
Other
Email Distribution Lists
Department or Shared Mailbox Access Needed (please list the names of the mailboxes, e.g. CON-OSAA mailbox.
Any other instructions
Submit
Should be Empty: