Request for JotForm

Requesters Name:*

E-mail Address:*

example@example.com

Department Name/Site:

Could you please tell us what you would like the title of the form to be?*

Would you like users to receive a pdf copy of the Paperless Platform once submitted?

Email Address of the person receiving submissions:

example@example.com

Additional email address for person receiving submission:

Do you need a Report sent to you or other team members?

YesNo

Would you like the report sent on a (weekly, monthly, or quarterly basis):

Please enter name and email address of report recipient(s):

Rows	Name:	Email Address:
Report recipient information 1:
Report recipient information 2:
Report recipient information 3:
Report recipient information 4:
Report recipient information 5:

Upload a copy of the paper form

Upload pdf or jpg:*

If you do not have a paper form, please list the questions you would like to include. Please note that these do not have to be finalized, we can edit them later.

Additional Info

Please verify that you are human*