Request for JotForm

Requesters Name:*

E-mail Address:*

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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:

[email protected]

Additional email address for person receiving submission:

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

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

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

	Name:	Email Address:
Report recipient information 1:
Report recipient information 2:
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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

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