Application to use private IT equipment

Application for permission to place private IT equipment on University College premises and/or connect equipment to the University College computer network.

I have read and understood the rules:

Name:               _________________________________________________________________

Student number: ____________         Username: ________________     Email: ________________

Study programme/place of study: ________________________

Phone/mobile phone:                   ________________________ 

I am registered as an active student and I have the responsibility for the following equipment:

Type of computer:      ________________________

Operating system:      ________________________

Ethernet address:       ________________________

Allocated IP address: ________________________         (to be filled in by IT Operations staff)

Place/address:            ________________________         (to be agreed with IT Operations staff)

Root password:          ________________________         (for server machines, changes must be notified)

The equipment is owned by:

Name:       _________________________________________________________

Name:       _________________________________________________________

The following persons will have access to it:

Name:      _____________________________________ Student number: ________________________ 

If there is not enough space please use a separate sheet for the name list.

Place        __________________________                                        Date: ________________________

Signature: __________________________

Permission given by IT Operations: __________________________  until : ________________________