Smartsheet Enterprise License Request

Smartsheet

Enterprise License Request

Please complete the form below to initiate a departmental, institute, and/or unit request for a DGSOM Smartsheet license.

Requestor Name*

First and last name of individual submitting request.

Requestor Email*

Email address of individual submitting request.

Requestor Department*

The department, center, and/or unit requestor is from.

Select or enter value

DSA Name*

First and last name of the department DSA.

DSA Email*

Email address of the department DSA.

CAO Name*

First and last name of the Chief Administrative Officer (or equivalent) for the department, center, or unit.

CAO Email*

Email address of the Chief Administrative Officer (or equivalent) for the department, center, or unit.

Unit Quantity*

Please clarify the number of licensed users being requested. Please note the cost is $499 per license.

Desired Start Date

Please specify the date you'd like the licenses active and assigned.

Names of Licensed Users*

First and last name of the individual(s) requiring licenses, separated by semicolons.

Emails of Licensed Users*

Email address of the individual(s) requiring licenses, separated by semicolons.

No PHI Attestation

I attest that no PHI (Protected Health Information) will be contained in Smartsheet, and that this user for whom the license is being requested is also aware of this restriction.

AP/Invoice Contact Name*

First and last name of the individual responsible for processing payment for the annual subscription cost.

AP/Invoice Contact Email*

Email address of the individual responsible for processing payment for the annual subscription cost.

Desired FAU

Notes

Please provide any additional information as necessary.

File Upload

(Not Required) Attach evidence of DSA and/or CAO pre-approval(s) if obtained in advance.

Drag and drop files here or

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