Sponsored User Account Application

Please complete and return both pages of the form to Information Technology Services or fax to (02) 4221 4596. Incomplete or unsigned application forms will not be processed. For further information refer to User Account Management Guidelines.

Applicant's Details

Title (please circle one): Mr / Mrs / Ms / Miss / Dr / Professor / Assoc Professor
Other:
First Name:
Surname:
Business Contact Extension / Phone Number:
Employee Number:
Faculty / Division or Organisation:
Unit (if applicable):
Have you ever held a (non-student) account with the University of Wollongong?
Yes       No 

Account Details

New Account Change Account Type Change Sponsor Reactivate Account
For change or reactivation of an account, please specify your username:

Disclosure and Consent

I agree to comply with the policies and procedures governing the use of the University of Wollongong IT facilities available at http://www.uow.edu.au/its. I also accept that my name and contact details will appear in the University Contact Directory while I hold the account, and declare that I am over 16 years of age.

I understand that this account is issued to me for the duration of my affiliation with the University only.

Your Privacy

The University privacy policy can be found at http://www.uow.edu.au/about/privacy/

Signature:
 
 Date:
 

Sponsor to complete and sign next page.

Office Use Only

Allocated Username:
 Allocated Alias:
Allocated UserID:
 Processed By:

Account Sponsor Details

All applications must be sponsored by the Head of Unit or equivalent or a delegated representative (sponsor). The sponsoring unit will be responsible for the cost of access to electronic resources. This includes any account maintenance and internet access charges. For a list of sponsors refer to https://intranet.uow.edu.au/.

Sponsor's name:
Sponsor's position title:
Sponsor's unit / organisation:
Sponsor's telephone extension:

Please indicate the sponsoring organisation / entity:
University of Wollongong (UOW) UOW School of IT & Computer Science (CS)
ITC Limited (ITC) ITC Education Limited including WCA (ITCE)
UniCentre (UNIC) University Recreation & Aquatic Centre (URAC)
Conservatorium of Music (CON) Exercise Science & Rehabilitation Centre (ESRC)
Chaplain's Office (CHAP) CRC for Welded Structures Head Office (CRC)
Richard Johnson College (RJC) Illawarra Regional information Service
Dubai (DUB)  

Select type of account: Staff *       Associate (Guest)** 
Sponsor's signature:
 
Specify first 3-digits of Cost Centre for UOW Associate (Guest) accounts:
 

* Staff accounts apply to individuals who are paid staff members of the University of Wollongong or one of its subsidiaries; or hold an honorary academic appointment with the University.

In addition, staff accounts may be held by emeritus professors and fellows of the University, as conferred by the University Council.

** Associate (Guest) accounts apply to individuals granted access to the University IT facilities by virtue of an affiliation with the University or one of its subsidiaries. Recognised affiliations are
- contractors and consultants providing services to the university or one of its subsidiaries
(typically involving a contract for services)
- visiting academics of the University other than those holding an honorary academic appointment
- members of the University Council
- members of a recognised business or community affiliate of the University of Wollongong.

Information Technology Services 
Phone: (02) 4221 3775              Fax: (02) 4221 4596

Last reviewed: 12 November, 2009