REQUEST FOR CUSTOM PROGRAMMING

Serial No.

Customer Name
Operator Name
Operator Email
Telephone Fax
Program # if applicable)
Custom
Proposed Standard Changes
Description of Request:

Gold Service
Platinum Service
Program needed by (Date)

If a new report is requested please attach or send an example to DataModes. If the request is for printing to a preprinted form please MAIL 15 to 20 actual forms and a completed example to the Quality Assurance Department at DataModes. This will increase the accuracy of the design, programming, and printing.

All proposed standard requests are reviewed by our APM committee. We would appreciate any background information regarding your business and how the requested change will benefit you as our customer. This is very helpful in the review process as it helps us to understand the necessity of the change.

Please send all additional information about either custom or APM changes via email at design@datamodes.com or fax us the information at (405) 947-5948.

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4200 Perimeter Center, Suite #202 Oklahoma City, OK 73112 (405) 947-3887
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