Client Information for On-boarding
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Form Contact Information
Full Name *
Phone Number *
Email Address *
1. Business and Billing Information
Business Name (DBA) *
Business Primary Site Address *
Business Telephone Number *
Business Fax Number
Business Billing Name (if different from above)
The name as it should appear on invoices
Business Billing Address (if different from above)
Billing Contact Person
Billing Email Address(es)
Please separate email addresses with semicolons
2. IT Support Preferences
Which staff person makes the IT decisions for the client (Site Decider).
Site decider's email address
Which staff person(s) is authorized to contact the Gennix Helpdesk
Named Staff Contacts from question above
Please put one name per line
Who are the key users on the client's staff
These are the VIPs for the client.  Please put one name per line.
Preferred methods to contact Gennix
3. Current IT Environment
Who is your internet service provider (ISP)?
What is your public domain name?
Company website address
What is your email hosting system?
Which server operating systems do you use within your organization?
Check all that apply
Which messaging server software do you use within your organization?
Check all that apply
Which database software do you use within your organization?
Check all that apply
Which desktop productivity software do you use within your organization?
Check all that apply
Which desktop operating systems do you use within your organization?
Check all that apply
Are you able to provide us with valid licensing documentation for the software checked above?
Clear selection
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