Physics Computer Services

Validated Internet Address Request Form

Also use this form to move a machine within Broida

The form for removing a machine from the network is located here.

Please fill in all boxes completely.
Incomplete forms can not be processed!!
Javascript must be enabled.
Please expect a 2-3 day turnaround, especially during peak periods.
Call us at x8366 if it is an emergency.

Please review the Physics Department Network Charges information to determine the level of service desired, and review the fee structure.

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Note: machines not currently on the Broida networks must be scanned for infections and vulnerabilities. This must be done before connecting to the network. PCS provides this service for free. Please contact us at ext 8366, or stop by Broida 5223. This process takes about one hour. Vulnerable or infected machines must be repaired before network numbers are issued.

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Required fields are indicated by *

Basic Machine Information
Desired Internet hostname* :		Ethernet Hardware Address*: Note, without your hardware address, we cannot process your request. Click here for information about finding your Ethernet Address.	:::::
In case that name is taken, please enter two alternative hostnames
1st alternate hostname :		2nd alternate hostname :
Additional machine identification information. This aids us in finding the correct machine in case of problems.
Machine Type (Sun, HP, etc.) *:		Machine Model (Sparc10, etc.)* :
Machine Serial No. :		UC Property No. :
REQUIRED Room location and EXACT wallplate and port to be activated. All wallplates in Broida are labeled in this manner. Other buildings have similar labeling schemes. Please fill in this information, or we are unable to activate the correct port for your machine.
Location (Ex: Broida 3332)* :		Wall Port (Ex: 5223 S1 D1)* :

Owner Specifics
Name of Princ. Investigator* :		Phone Number :
Your Department* :
Name of System Admin (you?)* :		Phone Number* :
E-mail Address* :
List Operating system and version* :

Accounting Information
Choose a service level: Note, you probably want Network Support as Isolated really is isolated from the Internet and the rest of Broida.	Network Support Isolated
Physics Account Code This should be a two character code assigned by the Physics Accounting Office We do NOT want a number with dashes here* :
Comments : If you are moving a machine from one location to another, please provide the old wallplate location here.

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Your form will not be accepted without the above validation.