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OFFICES & SERVICES

NETWORK CERTIFICATION FORM

< required fields in red > 
Name
 
   
Email Address
Verify Email Address
Reason for Visit
Name of Sponsor or Organization
Visiting Dates    
Type of Computer
Operating System (OS)
     
AntiVirus (AV) Program Name
Date of most recent AV scan
Do you need wireless access? Yes     No
Please Note: Requests for wireless access must be made three (3) day in advance of desired start date to accomodate processing time.
 
   
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