Web Form Request

for Enterprise Systems & Web Services, ITS

ITS asks for a minimum of two weeks lead time from the date you submit this form to the date you would like the form completed.

Name of Contact Regarding this Web Form Request * First Last
Contact's Academic Department/Administrative Office/Organization *
Contact's Email Address *

The contact's NetID
Contact's Telephone * - (###) - ### ####
Is this a request for a new form, or for the modification of an existing form? * I am requesting a new form I would like you to modify an existing form
If this request is for the modification of an existing form, please enter the web address of the existing form:
Preferred Title of New Form or Title of Existing Form *
Please upload a document which contains all the desired fields for your new form, or outlines the desired changes for an existing form
Does the form require an attached document of any sort (for example, a long summary statement or a resume)? * Yes No
Will the form require login through the F&M netID system (like when you log into myDiplomat)? * Yes No
For a new form, please enter the Franklin & Marshall email address of the person who should receive the data submitted through the form *

The persons NetID
For a new form, if there is a second address to receive the submitted data, please enter it here

The persons NetID
Do you want someone from ITS to add a link to your form on a web page? * Yes No
On what web page would you like to have a link to the form?
Is there any special text you would like to include with the link?
Do you want your users to recive a receipt of the submission when it is submitted? * Yes No
Additional Information and/or Special Instructions

Provide any special log in requirements, additional comments, or other specifications you would like to have built into your web form.
Date you would like your form completed. ITS asks for a minimum of two weeks lead time from the date you submit this form to the date you would like the form completed. * / MM / DD YYYY