Wireless Device Registration Request Form

Wireless Device Registration Request

Please use this form to submit information for your wireless device that requires registration on the network. This form is only for devices that do not have a browser. IT will review your information and determine if your device meets the requirements of the Network Use Policy. Please allow up to a week for review.

*
: This information is required

When you have finished, please click 'Submit' below.

User Details:

  • First name:
    *

    This response is required.

  • Last name:
    *

    This response is required.

  • Email address:
    *

    This response is required.
    This is not a valid email address.

Device Details:

  • Type of device:
    *

    This response is required.

  • Manufacturer:
    *

    This response is required.

  • MAC address of device (e.g., AA:BB:CC:11:22:33):
    *

    This response is required.
    This is not a valid MAC address.

  • Please give a brief explanation of what this device is and how you plan to use it on the wireless network:
    *

    This response is required.


Thank you for submitting your wireless device registration request. We will evaluate the information you have given and provide a response within one week.

There was a problem submitting your wireless device registration request. Please re-submit the information so that we can evaluate your request.