Server Request Form (Project)

Requestor name : Chan Seen Hon

BU/Department : ITAP

Contact Email : seen-hon.chan@lafarge.com

Project Manager

Application Services need to monitor Hostname IP address

JDE

Formscape /
Transform

BI / OSS

Maximo

Webmethod

Customer Portal
 RWDS

QIMS

Labmix/Bcmix

Workstation

Other (Specify)

Effective Date: - Permanent - Temporary date

___________________________________
Requestor Name, Signature and Date
 TP # :

Will be auto-populated

Date : 28 - 06 -13

Contact Tel : 012 -2998271

Infrastructure manager

IP address HDD CPU RAM Remarks OS PY/PD

 To be completed by the Requester

date to date

____________________________________________
Supervisor/Manager Name, Signature and Date
 System Administrator Application Owner

Quantity Expected Date Expected Date Expected date