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Affiliate Account Request Form

This account request form can be submitted to request temporary network accounts for affiliates as outlined on the Affiliate, Volunteer, and Contractor Accounts page. Affiliate accounts may be requested by University faculty and staff. Complete the form below and click on the submit button. Your request will be forwarded to the Help Desk. You will be contacted if there are any questions. Please allow two business days for account creation.

This form should only be used to request computer access for affiliates. For public wireless Internet access for visitors, connect to the VisitUR wireless network. This will give the user Internet access for 24 hours. 

University Faculty or Staff Sponsor:

Sponsor phone number:

Sponsor e-mail address:

Sponsor NetID:

First and last names of affiliates:

Reason for Access:

Access Needed Until:

Print Credits: YesNo

Number of print units per account:
If more than 50 credits are requested, the cost for printing is $2.00 per 25 pages per account.

Index and account to charge print units: 

Help Desk

(804) 287-6400
Jepson Hall, Room G-19

Monday-Friday: 8:30am-7:30pm

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Sunday: 10am - 4pm

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