XZERES IT Requisition Form
Please complete all fields.
Failure to do so will result in a delay in your IT Ticket.
Today's Date
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Requestor's Name
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Requestor's E-Mail
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Type of Change
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New or Temporary Employee
Office Space Currently Occupied?
Yes
Yes
No
No
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Office Location
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Current Occupant:
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New Employee Information
Employee Name
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Start Date
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Department
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Job Title
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Direct Supervisor
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Is this new hire replacing someone?
Yes
Yes
No
No
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Please Provide name:
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Access Required
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Hardware Requests
Laptop
Desktop
Desk Phone
Cell Phone
Tablet
American Express Card
Door Access Fob
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If necessary describe any special requests
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Account Creation and Modification Details
Model this AD Account after this person:
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Physical Location Details
Please indicate the office or cubile location of the Employee's new workspace.
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Enter any additional notes or comments here
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Delete/Change
Employee Name
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Describe the IT request here:
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Submit
Save
XZERES IT Requisition Form
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The email has been sent.
XZERES IT Requisition Form
Please complete all fields.
Failure to do so will result in a delay in your IT Ticket.
Today's Date
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Requestor's Name
{binding displayValue}
Requestor's E-Mail
{binding displayValue}
Type of Change
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New or Temporary Employee
Office Space Currently Occupied?
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Office Location
{binding displayValue}
Current Occupant:
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New Employee Information
Employee Name
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Start Date
{binding displayValue}
Department
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Job Title
{binding displayValue}
Direct Supervisor
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Is this new hire replacing someone?
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Please Provide name:
{binding displayValue}
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Access Required
{binding displayValue}
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Hardware Requests
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If necessary describe any special requests
{ binding firstError.message }
Account Creation and Modification Details
Model this AD Account after this person:
{binding displayValue}
{ binding firstError.message }
Physical Location Details
Please indicate the office or cubile location of the Employee's new workspace.
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Enter any additional notes or comments here
{ binding firstError.message }
Delete/Change
Employee Name
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Describe the IT request here:
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