Physics Department Computer Separation Form
(Please bring to PCS office or place in PCS mailbox when complete.)


First Name:							Middle Initial:			

Last Name:											

Username:											

Which doors did you have a PIN# for:							

Other aliases or usernames:								

List desktop computer(s) used:								

Who is your advisor or supervisor?							

Should your advisor or supervisor retain any of your files, web pages, or email?		
If yes, please explain and give instructions.


Which PCS servers did you use?			List date to remove account & files
(Check all that apply.)  			(Files will be removed day after separation date, if no other date is specified.)
   	- Physics file server (shell / MCP)							
   	- Physics web server 									
   	- Physics email server (see below for forwarding)					
   	- Administration server (Camaro)							
   	- Modem Pool (dial-in server)							
   	- VPN Server										

Which research servers did you use?		List date to remove account & files
   	- Vulcan										
   	- Cosmic										
   	- Yosemite2 (CPOS)									
   	- Other:	  										

Future email address:									
Starting when?			

IMPORTANT: Your Physics accounts will close 1 month after your separation date.

Choices for transitioning Physics email:  (Choose one – You cannot have both.)
   -  Forward Physics email to your future address for 1 month.
   -  Have an automated email reply for 1 month. Write message on back -->

Do you need info about having a username@alumni.physics.ucsb.edu email address? 
	Yes		No
									Date: