Student Account Request Form

Please complete and return this form to the attention of ASPIRE, c/o UAH Computer Science Department, along with a signed copy of the Computer Resource Usage Agreement (this agreement can be found at http://www.aspire.cs.uah.edu/accounts/rusage.html) and a signed copy of the parent letter(http://www.aspire.cs.uah.edu/accounts/parent.html).

If you cannot print legibly, you will NOT receive an account. Print large and clearly.

User Information:

Please print legibly or type! (Write N/A if item does not apply.)

Date: __________________

Name: ______________________________________________________________

Phone: (day) ______________________  (evening) _____________________

School Name: _______________________________________________________

School Address: ____________________________________________________

Your teacher's name: _______________________________________________

Purpose(s) of Account:

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________


Did you read and sign the Computer Resource Usage Agreement?  ______
(Please make a copy of the signed Computer Resource Usage Agreement
and file it with your other important papers.)

FOR ADMINISTRATIVE USE ONLY:

Username: ______________________
User ID: _______________________
Machine: _______________________
Type of Account: _______________________
Disk Quota (Hard/Soft): ________________________
Account Created By: ___________________________
Date Created: __________________________
Date Deleted: ______________________   Deleted By: ____________________
Verification Notes: ___________________________________________________
_______________________________________________________________________
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