Information Technology Request

[Firm Name]  is committed to purchasing and implementing information technology that helps improve the way we work.  Successfully selecting and implementing technology is a team effort between the Information Technology division and the users requesting the technology.

The following information will form a contract between IT and the requesting user in which IT will commit to implementing the approved technology and the user will commit to justifying the need for the technology and the time and effort necessary to ensure the successful use of the technology.

Requested By:                                            Request Date:  2/18/02

Industry Group / Division Request is for:

Describe the Item, Application, or Service you are requesting:

Describe the business benefit the technology will provide:

Check the type of services required to ensure successful implementation:

 New PC                                           Training Services

 Upgrade to existing PC                    Implementation Services

 New Package Software                    Custom Software Services

 Upgrade to Current Software                       Additional Hardware

Date Technology is Needed:         Date Negotiable:

Estimated Investment to Complete Request:

Hardware:               Software:                Consulting Services:       

IT Hours:                User Hours:       

Name of User who will be responsible for successful completion of request:

Approvals:                                                                   Completed:

_______________________________________      __________________________

Industry Group / Division Leader                                IT Supervisor

_______________________________________                  __________________________

Information Technology Director                                Date