Central, UNIX & WWW (World Wide Web) Account Signup Forms


To request departmental accounts, email its-consult@uni.edu with basic information about your departmental needs. For personal accounts, use the form below.


Departmental #_________________ Username _____________________


1. User Information: (please print)

Name ____________________________ UNI ID#___________________________
Department _______________________Phone____________________________
Address _____________________________________________________________ (street/office)    (city)    (state)    (zip)

2. Type of Request:

[    ] New
[    ] Renew and restore account ____________________________________

3. Services Requested:

[    ] Empty Web Space Account (http://www.uni.edu/<your Username>)
[setup nightly, account is your Username, initial password is 6 digit UNI-ID#]

[    ] Drupal Web Space Account (http://www.uni.edu/<your Username>)

[    ] MySQL Web Database Account (if setting up a web database for your web site)

4. Internet Access:
I have read the guidelines for Internet usage at http://www.uni.edu/policies/954 I understand and will voluntarily abide by these guidelines as established by Information Technology Services, the University of Northern Iowa.    I also understand and agree that my Internet privileges may be revoked if I fail to abide by the stated guidelines.

5. Account Information:

[    ] Faculty/Staff
[    ] Student

6. Signature _______________________________________________________________________

University users certify by signing this application that computing facilities will be used in accordance with applicable policies, including the Use of Computing Resources, of the University and ITS.
The University of Northern Iowa requests this information for the purpose of authorizing access to Information Technology Services computer systems. No persons outside the university are routinely provided this information. Release of any information is governed by Board of Regents rules and applicable state and federal statutes. A response under each item is required, your telephone number is optional. If you fail to provide the required information, the university may refuse to grant your request.

RETURN COMPLETED FORM TO: Information Technology Services 36 ITTC Mail Code: 0522 ATTN: CCC Manager    Last Update: 01-16-2013

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