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Existing/New Employee Hardware Request
Modern, Affordable, Efficient and Scalable IT.
Once you submit the request we will immediately start work on generating a quote! Thanks!
Employee Information
First Name
Last Name
Title
Department
Office/Direct Phone Number
Cellular Phone Number
Manager
Request Date
Hardware Quote Request
Requested Hardware Quotes
Desktop
Laptop
Monitor
Printer
Scanner
Other
If other, please list here
Software Request
List software requested
Will purchase be covered by grant funds?
Yes
No
Grant Name/Funding Source
Budget Amount
Additional Setup Information
Assigned Computer
New Computer
Existing/Repurposed
Serial Number
Computer Name
Email Address Needed?
Yes
No
Preferred Email Address
Is this new user replacing an EX MCJ employee who's login should be disabled?
Yes
No
User account that should be disabled
Other Additional Hardware
Requesting Admin Rep
Your Name
*
Phone Number
Your Email
*
Subject
*
Submit