Information Services - Software form

Your First Name*
Your Last Name*
Your E-mail Address*
IT Provider Name*
Budget Person First Name*
Budget Person Last Name*
Budget Person Campus Address*
Budget Person Campus Phone*

Needed for semester*
Are you using this software for a class?*	Yes No
If this software is being used for a course, please provide the course and key number below
Course Number
Key Number

Title of Software*
Manufacturer of Software*
On which platform(s) will this software run?*	Windows Mac Unix
Licensed For*	Faculty Staff Students

Did you purchase Technical Support?*	Yes No
Technical Support Website
Technical Support Phone
Technical Support Contact Person
Agreement Number

Level of support Provided* (Click here for definition of support levels)	Full Partial Transitional

Special Instructions (specific location, date etc.)