Contact Change Form
*Client ID:
*Person Requesting Change:
*Phone:
Date of Request:
Change Requested
Add
Remove
Contact Type
Description
License
Main Contact who receives license refresh.
Billing
Contact processes IRES invoices.
Client Site Administrator
The contact named by the client as the Client Site Administrator.
Marketing
Any client contact who wants to receive IRES product and marketing communications.
Ship
Contact who is to receive the product or supplies but the address is not to be used as the main address.
SMA
Contact processes/approves SMA renewal notice.
Third Party
Contact not employed by a client, needs to receive communication.
Change Detail
Title
Mr
Ms
First Name:
Middle Init:
Last Name:
Title:
Development:
Address 1:
Address 2:
City:
State:
Zip:
E-mail:
Phone:
Fax:
Other
Add
Remove
Newsletter Recipient
Receive Newsletter via E-mail
Yes
No
Do you want to receive info/mailings from your Regional User Group?
Do you want to receive Software Update Bulletins (product & hot fix information)?
Comments
*Required
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