First name:

Last name:

Email:

Dept/Org:

Phone:

SacLink ID:

The information provider of this account will be which of the following?

Faculty Staff Student Other:

Department or Program Center - Must be sponsored by a Department Chair or Program Advisor.
Institute - May require a sponsor or approval.
Student Organization - Must be sponsored by an Advisor.
Professional Organization - Must be sponsored by an Advisor.
Faculty - Faculty who work on their department's web page need Chair approval. Individual faculty pages do not need an approval/sponsorship.
Other May require a sponsor or approval.

Sponsor/Advisor's Information (if required - see notations above.)

Full Name:

E-mail:

Phone:

Department:

I am requesting for an individual faculty web directory (for faculty only).

I am requesting the following directory name: (e.g. http://www.csus.edu/irt) because:

Requested directory names are not guaranteed, unless they already exist.

By checking the box below, I certify that the requested Survey Account will be used for the work specified, that the proposed use of these computing services is justified by the programs of the CSU system. I further understand that unauthorized use of the CSU computing facilities is a violation of Penal Code 502 and, therefore, punishable by a fine not exceeding $5,000 and, imprisonment not exceeding three years and cancellation of accounts.

I have read and understand the above disclaimer.

IMPORTANT: All sponsor approvals will be verified with the person named. Please ensure that sponsor name, email address, and phone number (sponsor's info section) are correct or form may not be processed.