New Hosted VM Request

This form is used to request that EITS create a new Virtual Machine (VM) which we will host. This form will help ensure that we have all necessary information needed to get this request processed as efficiently as possible.

Requestor Information

Full Name: 

Job Title: 


Email Address: 

Phone Number:  

There is a cost associated with VM Hosting. By checking this box, you affirm that you are authorized to make this request on behalf of your agency.

VM Information

FQDN (Fully Qualified Domain Name): 

IP Address: 

Operating System: 

CPU Cores:    RAM: 

Storage Drives - 100GB Minimum (Storage space per drive.  If more than 1 drive, please indicate drive letter requested): 

User/Group who require vCenter access (if applicable): 

Budget Code to be billed: 

Maintenance/Monitoring Information

Which maintenance window would you look this server to be included in for OS Patching?

(We suggest test servers fall into Thursday’s window, and production servers on Tuesdays)

Please list email address which will receive Nagios server monitoring alerts:


Would you like the EITS Server Group to receive alerts for this machine regarding drive space and connectivity problems?

Additional Notes/Comments?