Network Access Request Form
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Check Appropriate Status: ____FACULTY ____STAFF
Complete Name:
Last Name First Name Middle Initial
________________________ ________________________
College ID Number Campus Phone
________________________ ___________________
Department Request Date
Your USERID/USERNAME will be your last name followed by your first initial. In the event of a duplicate
name, the username would be your last name followed by your first initial AND your middle initial. The ITS
department will notify the user of this occurrence.
Your temporary password is EC# followed by your college id number. For example, if your ID number is
1234567, your temporary password will be EC#1234567. Please make sure to type a capitalized EC.
Guidelines for the use of your computer account are set forth in the Employee and Faculty Handbooks.
Unauthorized transfer of a file OR unauthorized use of another individual’s identification and password is
prohibited. Distribution of your personal identification and password is also prohibited. Use of computer
facilities to interfere with the work of another student, faculty member, or college official may result in the
loss or suspension of your account.
By signing this document, you are acknowledging that you are aware of, and will abide by, the
rules and policies regarding use of the college’s computer facilities. Any violation of the above
mentioned rules will result in the loss or suspension of the violator’s computer account and
privileges, and possible disciplinary action. Any violations of applicable rules or policies may also
result in legal action taken against the violator.
Signature ______________________________________ Date ________________________
Network Accounts will take approximately 1-3 business days to setup. Once your account has been
configured, you will receive a confirmation phone call at the number listed above.
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To Be Completed by ITS
Username _______________________________ Password ________________________
Completed by _______________________________ Date ________________________
Employee information has already been submitted to ITS.
Information &
Technology Services
10/13/2011
click to sign
signature
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