Sponsored User Account Application

Version 1.0.8 - Dated 23.03.2012

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 (Intranet)

Applicant's Details - Please print clearly in BLOCK CAPITALS

Important information about the allocation of a Username for your UOW user account.
All UOW user accounts are uniquely identified by a username, where the username may be up to 8 alpha characters. The firstname and lastname details provided on this application are used to generate the username. The username is issued for the duration of your affiliation with the University. The facility does not exist to change a username however in the case of a legal name change where extraordinary circumstances justify a username change, an account holder may be issued a new account, after an application is made in writing and accepted by the Director, IT.

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):
Type of UOW 'staff messages' mailing list subscription	General Academic
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:
Subscribed to Mailing Lists

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 email address for notification of account creation
Sponsor's telephone extension:
Date: dd / mm / yyyy	/ /

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)	Illawarra Regional information Service
Chaplain's Office (CHAP)	Dubai (DUB)
Partner Group	UOW College Staff
SMART Collaborator

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

* 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: 16 April, 2012