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Port Activation Request


Port Request
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Are you a member of the Harvey Mudd College staff or faculty and wish to request a port installation? If so just fill in the form below and submit it. 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. This form is for Harvey Mudd College STAFF AND FACULTY ONLY, students may not request additional ports.

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.

Name*:
Department*:
Email*:
Extension*:

Please be as specific as possible filling out the installation information below

Installation Information:
Room/Area where you want the port installed*:
Is there a panel already installed (if there is, make sure you have checked all of the ports to seeo if they are active, especially the upper leftmost one)?*
Yes No
Date you need the port completed by (mm/dd/yyyy): / /

Additional instructions or clarifications?

THIS FORM IS FOR HMC STAFF AND FACULTY ONLY!
 (Students may not request ports)