IP Request Form
Use this form to request a fixed IP address for a computer. (You do NOT need to use this form just to be able to access the network - automatically obtaining an IP address via DHCP will work for most users.
Please allow a 48-hour processing period from the time when you confirm this request.
Please fill out this form. Once completed, you will recieve a copy of the data sent so that you may verify your request. CIS will then contact you if they need to finalize any details.
Fields with a red star (*) must be
filled in before the form can be submitted.
Please do not use the " character in any of the one-line text boxes as this may cause the information you entered to be lost.
HMC / Computing and Information Services/ email@example.com
Revised: Oct 10, 2008 by Dav Yust