Campus Domain Account Application Form
Please print the form, complete it and return it to: The Department of Information Technology, attn: Help Desk
Agreement: I have read, understand, and agree to comply with the CCRI Data Security Policy and the CCRI Policy on the Responsible use of Information Technology. I understand that I am responsible for any computing activity carried out using this account.
Applicant's Signature: __________________________________________ Date: _____________
Department Head's Signature:____________________________________ Date:_____________