(Faculty, Staff, Graduate Students and Sponsored Student Organizations)
Name of Applicant/Owner
NetID
Phone
Title
Institution
Dept
U-Box
University 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:
Enter a brief description of what this account will be used for below:
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***
