Request to join the Divisional PRISM subscription

This form should be completed by PRISM software managers/administrators only.

Use this form to request an annual departmental or group PRISM subscription or an increase to an existing quota.

The form cannot be used for an individual request for PRISM. Please contact your local departmental or group PRISM administrator.

For the current charge please see the GraphPAD PRISM information page.

This form should only be completed by the principle PRISM administrator for a department or group.

After you have submitted the form the MSD IT Admin Team will send you payment details.

Please do not place an order in R12 until you have received a reference number from the MSD IT Admin Team as you will need to quote it on the PO.

First Name

Last Name

Email address

Please supply your University email address

Department

Group name

Include your group name if you manage your own subscription, independently of your department

Total number of seats (activations) required

minimum 4

Billing email address (optional)

All billing correspondence will be sent to this address, if left blank it will be sent to the applicant.

Other PRISM administrators

Please list other any people who will be able to authorise activations (email addresses separated by a comma). (Note: The list will be reset each year and no one will be carried over from a previous subscription. The applicant will automatically be made an administrator. All administrators are added to a PRISM mailing list.)

Any other information

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Request to join the Divisional PRISM subscription