The University of Melbourne - Information Services

Declaration for Use of Local Computing Facilities

Surname: _____________________________________________



Given Names: _____________________________________________



Department: _____________________________________________



Telephone: _____________________________________________



Email: _____________________________________________

I, the undersigned, agree that:


Signature: ____________________________________ Date: ___________



Approved: ____________________________________ Date: ___________

(Head of Department or delegate)



Actioned: ____________________________________ Date: ___________

(Server Administrator)



Username: ____________________________________ System: __________________



Note: The University requires that all use of computing and network facilities be subject to and in accord with these conditions.