Your Name (required)

Company Name (required)

Full Address

City

State

Postal Code

Your Email (required)

New Employee's First Name

New Employee's Last Name

New Employee's Manager Name

Department (required)

Requested Username

Is there an existing user with the same permissions
we should copy for this new user?

Job Title/Description

Will this user be using a new or existing computer?
If existing, please provide the computer name

Requested Email Address

Email Distribution Groups (if applicable)

Software Needed

Printers Needed

Requested by what date/time

New user's telephone number and extension

New user's cell number

Anything else we need to know? If you did not specify a user whose permissions
we can copy, please specify what folder permissions they should have

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