Request for an IP Address

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Request for an IP address

required to attach any computer or terminal to the network

All Fields Are Required

Please fill out this form, print it, and submit it to Tom Hess

Date   Name

MAC address of the machine
       (ie. 00 50 00 ca 12 a2)            How to find the MAC address of your computer

Computer name requested
       (ie. Jones or Panda7x)

Machine Type (Manufacturer and Model)

UNM Inventory number
       (If not supplied, give reason ie: Personal machine, Sandia Labs machine)

Operating System
       (ie. Windows 2000, Windows XP, Windows Vista, Fedora 9 etc.)

       (ie. P&A, Room 171)

Primary Contact Person Phone Number
       (This is the person and phone number at or near this machine)

Wall Plate Connection Number
       (ie. 207-145-1365-68) NOTE: The 1365-68 signifies there are 4 sockets
       numbered Top Left=1365, Top Right=1366, Bottom Left=1367, and
       Bottom Right=1368. Please let us now which socket you will be using.

Date Machine activated