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New Employee Information

First Name

Last Name

State, Federal or Other Regulation's ID Number (e.g. NMLS)

Employee ID

Department and Position *

Start Date *

Office Location *

Street Address

City

State / Province / Region

ZIP / Postal Code

Manager Name

Company Email Address Requested *

Company Phone #/Extention

Alternate Email (for secondary authentication/password recovery) *

Mobile Phone # (for MFA)

Access Requirements

Name and Email Address of Existing Employee with Similar Access Rights

First Name

Last Name

State, Federal or Other Regulation's ID Number (e.g. NMLS)

Email *

Access Level/Permissions

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Standard User
Administrator
Other
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Access to Specific Applications/Systems

Email

ALIT DFS Training and Compliance Platform

CRM Software

Accounting Software

File Shares

Other

Specify CRM Software

Specify Accounting Software

Specify File Shares

Specify Other

Hardware Requirements

Desktop/Laptop

Desktop

Laptop

Tablet

Other (e.g. repurposing an existing workstation)

Desktop Serial Number *

Laptop Serial Number *

Tablet Serial Number *

Please Specify *

Additional Hardware Needs (if any)

Monitor(s)

Docking Station

Printer

Other

Other

Additional Information/Requests

Additional Software Needs (if any)

Special Requests/Notes

Notes/Comments

Requestor Information

First Name

Last Name

Requestor Email Address

Requestor Department/Position

Please fill out this form completely and click submit; our engineering team will be notified to begin processing the new user provisioning. For any questions or assistance, contact the Help Desk at (203) 936-6680 or [email protected]. Thank you.

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396 Danbury Road 

2nd Fl, Wilton, CT 06897

Client Support

(203) 936-6680

[email protected]

Support Center

Sales Inquiries

(203) 487-5795

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