Please fill in
ALL
applicable sections.
Computer Information Section
(How to find this information:) For a PC
click here
For a MAC
click here
SYSTEM NAME
(e.g. : DFPM-ADM-JFR)
SYSTEM MANUFACTURER
(e.g. : HP, Dell, Apple)
SYSTEM MODEL
(e.g. : iMac, MacBook Pro, HP Z400 Workstation)
Personal Information Section
YOUR UNID
(e.g. : u0123456)
YOUR NAME
Last:
First:
YOUR CONTACT PHONE #
YOUR EMAIL ADDRESS
Other people who will use this computer:
PERSON #2 UNID
PERSON #2 NAME
Last:
First:
PERSON #3 UNID
PERSON #3 NAME
Last:
First:
PERSON #4 UNID
PERSON #4 NAME
Last:
First:
If you have more than 4 people using this computer, PLEASE check this box, and we will contact you for the information.
rev. 07-20-2010