REQUEST FOR LAPTOP

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?
Is a Dual Monitor setup currently being used?

Yes No
Purchase or 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:
Should be Empty:

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