Workstation Request Form

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

First NameLast Name
Best Contact Number*

Area CodePhone Number
E-mail*
Preferred Delivery Date*

MonthDayYear
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 NameLast Name
E-mail Address*
Office Location/Site*
New User Start Date

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

First NameLast Name
Current Employee's Name*

First NameLast 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

Acknowledgment