HSFIS Report Request Form
HSFIS Report Development
Please complete to HSU Technical Dept.. Attention: Report Developer
Agency name:
Agency address:
Agency phone number: Agency fax number:
Contact/administrator name:
Position:
Phone: Fax: E-mail:
Header Information: (include report name and additional information in the header):
Place comments about Header information
Footer Information: (include any additional information in the footer):
Place Information about Footer.
Requested Fields (Place them in the order that you wish them to appear on the report): (Note: If you request more fields, please use another page)
Place information about fields needed in report. Field #1 Field #2 Field #3 Field #4
Group By (Enter field number):
1st:
2nd:
3rd:
Sort By (Enter field number):
Page orientation (circle one): Portrait or Landscape
Request signature:
Please note that there is a $75.00 per hour fee per report. A Report Developer will contact you within 24 hours (or n ext business day) to provide an estimated cost and delivery time.
HSU Technical Dept. Office Use Only:
Estimated number design hours:
Report developer signature:
Development start date: Report delivery date:
Developer design comments:
Additional comments: