Google Console Management

If this is a REORDER use the Short Form.

This End user form is used to accurately process your order with Google so the licenses being purchased are provisioned in the correct domain. Console licenses CANNOT be refunded, changed, re-distributed and must be provisioned in the correct Google Apps Domain at the time of order.

CTL Sales Order #:*

All CTL Sales Orders are 6 digits starting with 30#### or 41#### or something similar

CTL Sales Rep:*

End user Company Name:*

Company

End user Technical Contact name*

First NameLast Name

End user Technical Contact Phone:*

Area CodePhone Number

End User Technical Contact Address (Street, City, State, & Zip)*

End User Technical Contact Email Address:*

Email

Do you have Google Apps*

What is the Google Apps Domain where your licenses will be provisioned?*

Please use the above Google Apps Domain for all of my Google purchases*

Off Domain End user Email Address*

IF Off Domain Email Address contains the Google Apps Domain for purchase the SUBMIT button will be disabled. This address must be different to ensure email delivery notifications of the licenses.

Person who completed this form is authorized technical admin associated with this Google Apps Domain and understands all purchases are final and cannot be refunded, changed, canceled, etc. If this form is submitted with the incorrect domain and your order is processed at google using the incorrect domain, you will be required to submit a new purchase order with the corrected form to provision new licenses to the correct domain.

Signature*

Print Name*

Date

MonthDayYear

End user Technical Contact Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code