Neuro Information Technology
Windows XP Upgrade Request Form

Minimum specifications to support Windows 7

* Denotes required entry

First Name:
Last Name:
Department:
Phone:
Email Address:
Room Number:  
Computer Brand:
(Dell, HP, etc


Model Number:
CPU Type:

Memory:
Serial Number:
Please Provide Additional
Details or Comments

* For security reasons, please enter the characters
from the image below into the text box :