( The questions with * means Mandatory. )
 1. Name*
 2. Phone*
 3. Charger ID*
 4. Date Requested
 5. What is your campus mailing address?
 6. What is your Department name?
 7. What type of network access do you need?
 8. What type of device are you registering?*
     Note: Requests need to be approved. Submission of this form does not guarantee access to the UAHuntsville network.
    Printer (anti-virus not required)
    If Other, please specify 
 9. Where is the device located? *
     Note: If you are requesting network access for a lab of computers, please attach a spreadsheet to the incident that is created by this request that contains information for each of the workstations.
    Original Building-Room (if the device is being relocated) 
 10. What operating system (OS) is running on the machine(s)?*
 11. What is the device's MAC Address?*
     To find your device's MAC address, refer to Devices - MAC and IP Addresses
    Physical Address (in ipconfig):
 12. What is the device's Internet Node Name?
     Note: Network Services reserves the right to assign node names. The following request will be honored if possible.
    System Name 
 13. What is the device's domain (if it is not uah.edu)?
 14. If you are requesting to delete an IP Address, please provide the IP address.
 15. Who will be performing Antivirus Scans and System Updates?*
     Antivirus scans, virus protection software, and operating system updates are required by i.t.solutions prior to a device being connected to the UAHuntsville network. If the scanning and installation of this software and updates is completed by a server administrator, access to the network may be expedited more quickly. Typically for a new workstation, TAG performs these operations, so the fulfillment time will be extended nominally.
    Administrator making the request
    When were updates completed? 
 16. Do you comply with network policies?*
     In making this application for computing resources I hereby consent to the monitoring of my usage of these computing resources for the purpose of detecting unauthorized use and accounting. I further understand that any unauthorized usage would make me subject to disciplinary action and/or criminal prosecution. I acknowledge that I have read the UAH Computer Security and Usage Policy and agree to its terms.
    I comply
    I do not comply (Access will not be granted)