POLYTECHNIC STUDENT HOME PAGE APPLICATION FORM
(Print and return this completed form to the I.S. Help Desk)

In order to have student Web pages on Polytechnic's student server (utopia.poly.edu or kepler.poly.edu) and to have your name and home page listed on Polytechnic's WWW site, you agree to the following:

Polytechnic University and the Information Systems Department reserve the right to remove any student pages in violation of this signed agreement. Severe violations can result in loss of computing privileges at Polytechnic University, academic discipline and/or notification of local and federal authorities.

I agree to abide by the above rules.

Signature:________________________________ Date:______________________

Name:___________________________________ ID #:_______________________

Electronic mail address:(required)______________________@utopia.poly.edu


__________________________For_Office_Use_Only________________________

Added by:_________________ Date:______/______ Time:_________:_________