ICT REQUEST FORM

Personal Details:

First Name: (Mr./Mrs./Ms):

Surname: Initials:

College Staff	Support Staff
CEST CBHS CAFF CMNHS CHE NTPC TVET	ICT Academic HR Planning & Dev VC Office Registrar MD Library Secretariat Payroll Finance Facilities
Department:	Department:

Job Title:

Location (Campus): Room No:

Ext No: Fax No:

Justification for Requisition (Specify your device e.g. PC, Laptop, Printer, Multimedia, Telephone, etc)

Software Approved	Approved Additional Applications
MS Office PDF Reader WinRAR	Premium Navision PayGlobal Alice

Other Software (please specify)

Approved by:

Department Head/Dean/Manager: Name: Sign:

Date:

Department/College Stamp:

FOR ICT USE ONLY

Computer Name:	Model/Brand:
Specs (High/Low): High Low	Software Request Configured (Yes/No): Yes No
Serial No:	User Data Transfer/Email Configured: Yes No