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Dial-in Application Form

Please print out this application form before you fill it in.

Return to:

Academic Computing Center, Stokes 204, (610) 896-1045

Please remember to enclose a personal check with your order.


Date:

Name:

Status:

Faculty Staff Student

Dept./Class:

Email address:

Address:

City:

State:

Zip Code:

Work Phone:

Home Phone:



Please answer the following questions about your computer and modem:

Type of computer:

Macintosh (Mac OS 8.5 or later)
Windows 98/XP Pro PC
Other ( ) (Note: Not supported)

Computer model:

(i.e. PowerBook G4, Dell Dimension 4550)

Memory:

MB (megabyte)

Hard disk capacity:

GB (gigabytes)

Operating system version:

Modem model:

Modem speed:

2400 9600 14400 28800 33600 57600 Other ( )


One time registration fee of $25 per user to be included with this order form. Fee is waived for students.

I have read and agree to abide by the Acceptable Use Policy. I understand that violation of these policies is grounds for discontinuing my dial-in service to Haverford's network. I have also read and agree to the dial-in support policies. I understand that this account is for my personal use only and will not share it with my family members or friends.

Signature ____________________________________________


Return to Dial-in Service Home Page

For Questions and Comments, contact Haverford College's Academic Computing Center.
Last updated on May 7, 2003

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