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Administrative CMS/Mainframe Account Application

Name

Phone
Title

Institution

Department

Unit
(U-Box)
Univ. Dept #
Details of the account will be sent to you through the mail.
Check one: * NEW       RENEWAL      CHANGE
CMS ID (will be assigned for new accounts)
Any special request, or quantity of CMS cylinder space to be altered?
*Brief Purpose of Account:
I agree to abide by the rules governing the use of computing resources. I will not allow anyone to use this account unless I notify the Accounts Office in writing, and determine that the individual understands the rules and agrees to abide by them.
Signature of account holder:____________________________Date:___________
Name of Dept. dean / director (please print): ______________________________________
Signature of depts. dean/director:________________________Date:___________

Fill out, print, sign and fax to: 486-4131 or send to:
UITS 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
         
Form Updated: February 09, 2006

Page Updated: 10.13.lab