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info@ncsmidwest.com

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Client Onboarding

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Company Name *

Company Address *

Address Line 1

Address Line 2

City

State

Zip Code

Main Point of Contact

Name *

First

Last

Phone

Email *

Billing Point of Contact

Name *

First

Last

Phone

Email *

Local Domain Information

Domain (please click yes or no):

Yes
No

Domain Name:

LAN Information

LAN IP Scheme

LAN Subnet Mask

LAN Gateway

VLAN's (check yes or no) *

Yes
No

List out VLAN's and their purpose:

WAN Information

ISP

WAN IP's

WAN Subnet Mask

WAN Gateway

Firewall Information

You will be provided a secure link to upload the credentials.

Make/Model

IP

Does it have manufacturer support or warranty?

Yes
No

Support or Warranty Expiration

Security Services

Yes
No

List of Security Services:

Security Service Expiration(s):

SSLVPN

Yes
No

Network Switch Information

You will be provided a secure link to upload the credentials.

Layout

Make/Model

IP Address

Check the box to add another switch:

Add Switch

Layout (copy)

Make/Model

IP Address

Check the box to add another switch:

Add Switch

Layout (copy) (copy)

Make/Model

IP Address

Check the box to add another switch:

Add Switch

Layout (copy) (copy) (copy)

Make/Model

IP Address

Check the box to add another switch:

Add Switch

Layout (copy) (copy) (copy) (copy)

Make/Model

IP Address

Check the box to add another switch:

Add Switch

Layout (copy) (copy) (copy) (copy) (copy)

Make/Model

IP Address

Wireless Information

You will be provided a secure link to upload the credentials.

Make/Model of Access Points:

Controller:

Yes
No

IP or Web Address of Controller:

Layout

SSID:

SSID:

Choose from the Dropdown

VLAN:

Check the box to add another SSID:

Add SSID

Layout (copy)

SSID:

SSID:

Choose from the Dropdown

VLAN:

Check the box to add another SSID:

Add SSID

Layout (copy) (copy)

SSID:

SSID:

Choose from the Dropdown

VLAN:

Check the box to add another SSID:

Add SSID

Layout (copy) (copy) (copy)

SSID:

SSID:

Choose from the Dropdown

VLAN:

Physical Server Information

You will be provided a secure link to upload the credentials.

Layout

Make/Model:

Hostname:

Service Tag/Serial Number:

IP Address

Hypervisor Host:

Yes
No

Layout

Purpose:

O/S:

Hypervisor:

Please choose from the dropdown options.

Check the box to add another physical server:

Add physical server

Layout (copy)

Make/Model:

Hostname:

Service Tag/Serial Number:

IP Address

Hypervisor Host:

Yes
No

Layout (copy)

Purpose:

O/S:

Hypervisor:

Please choose from the dropdown options.

Check the box to add another physical server:

Add physical server

Layout (copy) (copy)

Make/Model:

Hostname:

Service Tag/Serial Number:

IP Address

Hypervisor Host:

Yes
No

Layout (copy) (copy)

Purpose:

O/S:

Hypervisor:

Please choose from the dropdown options.

Check the box to add another physical server:

Add physical server

Layout (copy) (copy) (copy)

Make/Model:

Hostname:

Service Tag/Serial Number:

IP Address:

Hypervisor Host:

Yes
No

Layout (copy) (copy) (copy)

Purpose:

O/S:

Hypervisor:

Please choose from the dropdown options.

Check the box to add another physical server:

Add physical server

Layout (copy) (copy) (copy) (copy)

Make/Model:

Hostname:

Service Tag/Serial Number:

IP Address:

Hypervisor Host:

Yes
No

Layout (copy) (copy) (copy) (copy)

Purpose:

O/S:

Hypervisor:

Please choose from the dropdown options.

Virtual Server Information

You will be provided a secure link to upload the credentials.

Layout

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy) (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy) (copy) (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S:

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy) (copy) (copy) (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy) (copy) (copy) (copy) (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S

Check the box to add another virtual server:

Add Virtual Server

Layout (copy) (copy) (copy) (copy) (copy) (copy) (copy) (copy) (copy) (copy)

Virtual Machine Hostname:

Purpose:

IP Address:

O/S

Application Information

Layout

Software:

License Key:

Support Contact Information:

Check the box to add another application:

Add application

Layout (copy)

Software:

License Key:

Support Contact Information:

Check the box to add another application:

Add application

Layout (copy) (copy)

Software:

License Key:

Support Contact Information:

Check the box to add another application:

Add application

Layout (copy) (copy) (copy)

Software:

License Key:

Support Contact Information:

Check the box to add another application:

Add application

Layout (copy) (copy) (copy) (copy)

Software:

License Key:

Support Contact Information:

Computer Information

Quantity of Windows Computers:

Quantity of MAC Computers:

Public Domain, DNS, & Hosting Information

You will be provided a secure link to upload the credentials.

Layout

Public Domain Name:

Public Domain Registrar:

Check the box to add another public domain:

Add public domain

Layout (copy)

Public Domain Name:

Public Domain Registrar:

Check the box to add another public domain:

Add public domain

Layout (copy) (copy)

Public Domain Name:

Public Domain Registrar:

Check the box to add another public domain:

Add public domain

Layout (copy) (copy) (copy)

Public Domain Name:

Public Domain Registrar:

Website Address:

Website Hosting Provider:

Website Hosting Provider Contact Information:

Public DNS Provider:

E-Mail Information

You will be provided a secure link to upload the admin credentials.

Email Provider

Please choose from the dropdown.

Hosted Provider:

Cloud Provider:

Quantity of E-Mail Addresses:

Contact Information for Support*:

*If Microsoft 365 or Google, no need to provide.

Additional Notes:

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Address

108 SE. 29th St. Topeka, KS 66605

Call Us

+1-785-267-7977

Email Us

info@ncsmidwest.com

We work with businesses and organizations to increase productivity and profitability through the intelligent application and management of information technology solutions.

Pages

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About Us
Technology Solutions
Contact Us
Join Our Team
Remote Support

Topeka
108 SE. 29th St.
Topeka, KS 66604

Kansas City
9620 E 350 Highway, Suite 103
Raytown, MO 64133

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