Client Contact *

First

Last

New User Info

User's Full Name *

First

Last

Requested Email Address *

User's Phone

Title

New User's Start Date *

User Computer Info

Computer to Use

• Purchase Computer
• Existing Computer

Include any details on Computer to Purchase (if any)

Enter name of Existing Computer, or any additional details

Software

Select all that apply

• ACT!
• Adobe Acrobat Reader (free)
• Adobe Acrobat Pro
• Adobe Creative Cloud
• AutoCAD
• MiSys
• MS Office (Word, Excel, PowerPoint, Outlook)
• QuickBooks
• Other

Other Software

Web Browser Preference

• Google Chrome
• Other

Enter preferred Web Browser

Network

Remote/VPN Access

• Yes

Network Shares

• Accounting (K:)
• ACT (X:)
• Corporation (W:)
• Human Resources (N:)
• Installs (O:)
• Manufacturing (P:)
• Publicly Releasable (R:)
• Publishing (S:)
• QuickBooks (Y:)
• Sales Database (U:)
• Sales (T:)
• Service and Support (V:)
• User Share (L:)
• ZBE (Z:)
• Check All the above
• Other

Other Network Share

Printers

Select all that apply

• All Printers
• Other

Other Printers

Other

Please include any additional notes or details (if any)

Submit