New Computer / User
Computer Type
*
Desktop
Laptop
Salesman Laptop
Executive Desktop
Executive Laptop
Existing Computer / Laptop
If Existing, Previous User
AEG Supplied Hardware
HP Printer
Scanner
Web Cam
LCD(s)
Keyboard / Mouse
Other
Paradigm Supplied Hardware
HP Printer
Scanner
Web Cam
LCD(s)
Keyboard / Mouse
Desk phone
Other
Location
HQ
El Reno
Lubbock
Dalhart
San Angelo
Panhandle
Other
If other:
Shipping or drop off location
HQ
El Reno
Lubbock
Dalhart
San Angelo
Panhandle
Other
If other or additional shipping information.
New or existing User
New
Other
If New user:
Name
First Name
Last Name
Server Username
RAX Username
Email Address
Additional Email address
aegpetroleum.com
nexoiltx.com
Other
Office 365
Full
Web
Email only (Driver)
Server Applications installed on local computer
Rax
Fuel Master
Adobe Pro
Adobe Illustrator
Other
Remote Access Applications
RAX
Quick Books AEG
Quick Books Nexoil
Client VPN Access
Other
Network printers required, Please include IP Address if possible
Additional Notes / Requests
Submit
Should be Empty: