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.

Your personal information
Full Name*:
Email*:
Computer Name*:
Graduation Year*:

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HMC / Computing and Information Services/ webmaster@hmc.edu

Revised: July 9, 2007 by Jose Moreno
URL http://www.hmc.edu/comp/services/forms/account-request.php