REQUEST TO USE CENTRAL COMPUTING FACILITIES

Part 1

Family name ……………………………………………………………  
Given names ……………………………………………………………
Title ……………………………………………………………………
Department …………………………………………………………….
Previous login (if applicable)………………………………………….....
Room Number …………………….. Telephone Number ……………………………….

Staff     Visiting Academic [ ]    Temporary Staff [ ]  (Please tick one box)
  
Guest [ ]  Please fill in Part 3 (after reading 'Eligibility for Access to Central Computing Services'.

I apply to use the Computing Service and agree to abide by the ‘Guidelines for Use of IT Facilities’ - see web page: http://www2.essex.ac.uk/cs/about/regulations/

Signature …………………………………………………. Date …..…/…..…/…..….

Part 2
 
Departmental authorisation

Expiry date (end of contract or visit)

…………………………………………………...
(MUST BE FILLED IN)

Signature …………………………………………………. Departmental stamp
Printed Name ……………………………………………...
Position ……………………………………………………
Date ………………………………………………………..

Part 3

Guests only

Address  …………………………………………………………………….………………..
…………………………………………………………………………………………………
Contact Telephone Number: ……………………………………………………………………

Computing Service authorisation

Signature ………………………………………………………………………………..
Comments ……………………………………………………… Login name …………………
(staff2.doc)