New User Fields marked with an * are required Contact InformationPlease make sure to check this section for accuracy as it will be used to contact you as we process your request. Company Name* Full Name* First Name Last Name Email Address* Phone Number*Enter the best phone number to reach youHow would you like us to contact you?*Please selectEmailPhoneNew User InformationFull Name of New User* First Name Last Name Please enter full name of new userRequested E-Mail Address* Start Date* MM slash DD slash YYYY Department* What department will the new user be working in?Copy User?* Is there a current user in the company that we can copy for permissions for this new user? If so, please enter their name.Anything aside from standard setup?* Yes No Will this user need any special setup? Any special permissions? Any printers other than the defaults? If yes, please detail in notes field below.Notes*Remark: We will collect your information for marketing purposes. However, we respect your privacy rights. If you wish to access or amend any Personal Data we hold about you, or request that we delete any information about you that we have collected, please send us an email: marketing@dpctechnology.com* I agree to the Terms of Service and the Privacy Policy Remark: We will collect your information for marketing purposes. However, we respect your privacy rights. If you wish to access or amend any Personal Data we hold about you, or request that we delete any information about you that we have collected, please send us an email: marketing@dpctechnology.comEmailThis field is for validation purposes and should be left unchanged. Δ
