NetUser_Request

Network User Information Request Faculty and Staff: There is a $275.00 annual fee for network access. Fill out a requisition and forward it to the business office. You will be notified when it is approved. For more information, please contact the DITS Help Desk at 404-752-1111, option 3. There is no charge to MSM Students or Residents for network access. If your request is for a new or replacement account, a supervisor or department head must fill out and sign this form on user's behalf. If you are already a network member and requesting additional network software or services, supervisor signature is required except for Research Software titles. *Please Print the completed form before you press Submit.*
*Account/Payment Status:*
Supervisor
This is a(n): New Account Replacement Account Existing Account If replacement, user is replacing connection for Requisition or PO Number is required for New or Replacement Accounts: Requisition No. or Purchase Order No.
*User Information:*
Name	Job Title
Dept	Location
Voice # FAX # Pager #
If Assigned: User ID Password

Computer Information:
Computer Manufacturer			If Other, which?
O/S Model			If Other, which?
Processor			If Other, which?
Modem Type			If Other, which?
Network Adapter			If Other, which?
Network Information - check all that apply:
Access Network Access	Remote Access
*Windows* Network Printers - Please Specify below: 1) and 2) (example: \\servername\printername) Network Folders and Files - Please Specify below: 1) and 2) (example: \\servername\foldername\filename)
Software The following titles are standard installs on all networked computers (no request necessary):
Internet Explorer Anti-virus Software Adobe Acrobat Reader
Administrative Software:
Raiser's Edge ePAS Colleague
Research Software (supervisor's signature is not required for the titles below):
Delta GraphPro EndNote InStat MapInfo Reference Manager SAS SigmaPlot SAS		SigmaPlot SigmaStat SlideWrite Plus SPSS Statistica StatView Sudaan SAS-Callable Systat
Other software - which? 1) and 2)
Training Please contact me about desktop software training classes.
Signature
Supervisor Signature
Date
Please Print this form before you press Submit. Then sign and date it, and deliver or FAX it to the DITS Help Desk (Research Wing Room 103, FAX 404-752-1971). New account requests also require a signed requisition. When your request is approved, we will contact you.