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Telecommunications & Network Services

Network Service Request

Use this form for all network service requests, regardless of the type of connection. Please enter all fields as accurately and completely as possible. The following information refers to the person who uses or will use this service. Please provide information for that person.

(* Required Fields)

NETWORK SERVICE REQUEST
* User First Name:
User Middle Name:
* User Last Name:
* User Category:	Faculty	Staff	Student
* Department:
Please enter the building and room number where the user is located.			* User Location Bldg/Rm:
* Contact E-mail Address:
Please enter a telephone number for contacting the user, including the area code if necessary. If the number is a campus number, then enter the 5 digit extension.			* User Phone Number:
If we have questions about your request, do you prefer we contact you by phone or e-mail?			E-mail	Phone
Which type of request are you making?	New network connection	Move network connection	Request static IP address	Report network problem * Must include IP and/or MAC address for each connection.
If new, move, or problem network connection, please enter the jack number associated with this connection. The format for this number is #.#.###			Current Jack Number:
If move network connection, please enter the jack number associated with the new location.			New Jack Number:
If move network connection, please enter the new location (i.e., location to which the equipment will be moved, not the “User Location” you entered above).			New Location Bldg/Rm:
If IP request, to which subnet should the IP address belong (e.g. for the IP address 146.244.132.0, the subnet is 132)? What is the subnet mask (e.g. 255.255.255.0)? Contact your department's Technical Contact if you do not have this information.			IP: (e.g.: 146.244.132.0) What is an IP address? What is the difference between a "static" and "dynamic" IP address?	Subnet Mask: (e.g.: 255.255.255.0) Justification: (e.g. We need a static IP address for a printer that will be part of the College of Arts and Letters network.)
* For network requests, please include both the IP and MAC addresses. Instructions on how to find a MAC and IP address. IP: MAC:
* Please provide a brief description of the work or problem:
Equipment Information The following information refers to the equipment for which this service is being requested.
Equip. Make and Model:
Please enter the building and room number of the equipment if other than “User Location” specified above.			Equip. Location Bldg/Rm:
Please enter the property ID number. The format for state ID numbers is “E######.” or “C######” Foundation ID numbers have the format “######” and AS numbers have the format “####.” Note that leading zeros are significant.			Equip. Property ID:
Equip. Tag Type:	SDSU	Foundation	Assoc. Students
Please enter the serial number of your machine.			Equip. Serial Number:
What type of connection do you want? Connect To:			Ethernet	Other
If you selected “Other,” (non-Ethernet connection) specify type:	Other	ITT terminal to IBM controller	Terminal to terminal server
If you selected “Other,” (non-Ethernet connection) please describe the connection you want in more detail:
Charge Account Information Please enter the name of the account administrator for the account. We will clear all charges with this person prior to processing chargeback requests. Disregard this field for state-owned equipment.
* Acct. Admin. First Name
* Acct. Admin. Last Name
Enter your account number Format: SDSU Oracle accounts: #####.###.#####.####.####.####.0000 [Oracle accounts are 35 characters long (with dots)] Foundation accounts: ###### ##### Associated Students accounts: #-##-###-####
* Account Number:
Please enter the campus phone number of the signatory given above. Disregard this field for state-owned equipment.
* Acct. Admin. Phone:				Format: 4####
Primary Contact Information You may specify a primary contact. If you choose one, please notify them that they will be called upon to assist us. Please choose someone in the proximity of the equipment that needs service; someone who can give us key access to the room. Providing a contact will help to speed the completion of your work request.
Contact First Name:
Contact Last Name:
Contact Bldg/Rm:
Contact Phone:
* Contact E-mail:

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This page last updated March 27, 2008
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