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Homepage Account Request

(Faculty, Staff, Graduate Students and Sponsored Student Organizations)
Name of Applicant / owner

NetID                      Phone
Title
Institution
Dept
U-Box            Univ. Dept #
Official UConn E-Mail address
Details of the account will be sent to you through the mail.
Netid of individual who uses this account: 
Check one: * NEW       RENEWAL      CHANGE

Homepage userid *

 *(will be assigned for new accounts)
Brief description of what this account will be used for:
I agree to abide by the rules governing the use of computer resources. I have read Individual Responsibilities with Respect to Appropriate Use of Information Technology Resources found on http://itpolicy.uconn.edu/ . I will not allow anyone to use this account.
 
Signature of applicant/owner::________________________________________Date:___________

Fill out, print, sign and fax to: 486-4131 or send to:
UITS Help Center / Accounts Office
196 Auditorium Road, Unit 3138
Storrs CT 06269-3138

***PLEASE DO NOT WRITE BELOW THIS LINE - FOR OFFICE USE ONLY***

Name:
Acct:
Machine
Code
Type
         
Last Updated:July18,2006