IT Site Survey

If this site survey is for multiple machines, fill the form out multiple times changing information that corresponds with each machine.
Fields marked with a "*" are required.

Account Representative
Indicate the name of the Sharp Business Systems Account Representative that assisted with this purchase.
Company Information
Company Name*
Street Address*
City, State ZIP*
Key Contact*
Phone Number*
IT Information
Key Contact*
Company Name*
Phone Number*
Type* On-Site
Current Network Environment
Please check all boxes that apply for your current network environment. IP address information for this section is not required, but does speed-up the installation process.
Topology/Cabling* Ethernet
Fiber Optic
Protocols* TCP/IP
Server OS* Peer-to-Peer (no servers)
Windows 2003
Windows 2003 SBE
Windows 2000
Windows NT 4
Linux ®
Macintosh ®
Novell Netware ®
IBM (AS/400) ®
DNS IP Address(es):
Reverse Lookup Enabled
LDAP IP Address:
Search Root:
DHCP IP Address:
Workstation OS Information
Please indicate the estimated number of workstations that will be using the multi-function printer, according to operating system.
Win XP Pro (# of workstations)
Win XP Home (# of workstations)
Win 2000 Pro (# of workstations)
Win ME (# of workstations)
Win 9x (# of workstations)
Win NT (# of workstations)
Macintosh (# of workstations)
Terminal Emulators (# of workstations)
Other Name(s):
(# of workstations)
Proposed Product
Please provide us with RESERVED IP information for the multi-function printer that is to be networked. Subnet mask is required for all network connectivity, but gateway can be left-out if the multi-function printer does not need to go out to the Internet for any of its communications. These fields can only be left blank if machine is to be used as a USB or Parallel printer. See next section for options.
IP Address*
Subnet Mask*
Gateway (If applicable)
Expectation Information
Network drops installed?* Yes, No, NA
Electrical Outlets Installed?* Yes, No
Is this a printer replacement?* Yes, No
Expected Connection* Network
Provide all Cabling?* Yes, I agree to provide all necessary cabling, including network, parallel, and USB,
No, please provide me all cabling and bill me applicably
Type of printing* Server-based printing
Direct IP printing
Scanning Options
There are three scanning options available with our equipment. Please note which scanning option you would like to use, if any, and fill-out any required information to go with it.
Scan to FTP? Yes, No
FTP Address:
Requires Login
Scan to E-mail? Yes, No
SMTP Address:
Type (e.g., Exchange 2003):
Internal, External/ISP Hosted
Relay On, Relay Off
Scan to Sharpdesk ®?
(Scan to Desktop)
PLEASE NOTE -- Scanning to Sharpdesk ® software requires local administrator rights to INSTALL the application itself, and requires a port to be opened up on the computer, used for transferring the data from the Sharp MFP to the computer.
Yes, No
Number of workstations that need software installed, 10 max.
Other Information
Anything that you think we should know about before we begin the installation process can be noted here. This can be anything from future network changes to general comments or suggestions.