Workstation Request Form

     Name:  

      Email: 

Company:  

    Phone:  

I would like a:	Minitower	Small Form Factor
	Laptop  Screen size: 15"  17"
Memory:	512 MB  1 GB  2GB
Monitor:	17"  19"  None
Optical drive:	CD/DVD  CD/DVD-RW
Microsoft Office:	Basic (Outlook, Word, Excel) Standard (Outlook, Word, Excel, PowerPoint) Small Business (Outlook, Word, Excel, PowerPoint, Publisher) Professional (Outlook, Word, Excel, PowerPoint, Publisher, Access) None
End User's Name:
Does the End User need data migrated off the old computer?   Yes No
Will the old computer be redeployed?  Yes  No
I would like to have the computer installed by the following date:    MM/DD/YYYY
Additional Notes:

Champ Systems, Inc.  Privacy Statement
Champ Systems, Inc. (CSI) is committed to protecting your privacy. This Privacy Statement applies to data collected by CSI through its Web site, as well as its offline support services and billing system. CSI collects and uses your personal information to deliver the services or carry out the transactions you have requested. We also use your personal information to communicate with you. We may send certain mandatory service communications such as welcome letters, billing reminders, information on technical service issues, and other announcements. We may also occasionally send you product/service surveys or promotional mailings to inform you of products or services available from CSI and its affiliates. Personal information collected on CSI sites and offline support services may be stored and is processed in the United States.
Sharing of Your Personal Information
Champ Systems, Inc. will not disclose your personal information outside of CSI and its controlled subsidiaries and affiliates without your consent. CSI will not sell, rent, or disseminate your personal information to any other source or entity unless required by law.