FIRST-YEAR STUDENT REQUEST FOR KSUCVM NETWORK ACCOUNT

            Please fill out the following information and submit.
If you have any questions, please contact:
                            DeAnna Jacklovich or Eric Herrman
Network Administrator
406 Trotter Hall
            Please allow 24 hours for creation of new accounts. You  will receive your password
            information with your new tablet, along with helpful information about using the network
            during orientation in August. 

                                                     
INFORMATION IS USED TO CREATE USERNAMES & PASSWORDS
     If any information is filled out incorrectly on this form your account will not be created.

        Status?: (Veterinary Student only selection available.):

                                             

        First Name :    

       

        Middle Name :

        Last Name :     

       

        Class Of:     

        K-State eID: @k-state.edu

        Birthday(MM/DD/YYYY):

The application for new accounts requires that the user agree and abide by all policies of the KSU College of Veterinary Medicine and those
of Kansas State University. You can find the network policies for Kansas State University here: http://www.k-state.edu/its/policies/

You can find the College of Veterinary Medicine policies here: http://www.vet.k-state.edu/education/handbook

By typing in your First and Last Name below and clicking submit you agree that you have read through all of these policies and understand
and agree to abide by all network and e-mail use policies set forth by Kansas State University and the KSU College of Veterinary Medicine.
You also agree to the responsibility for all transactions associated with your network and e-mail accounts.

Signature: Date: