Network Services Registration
1. Contact information
*
administrator name:
department:
phone number:
e-mail address:
Date of request:
*
mm/dd/yyyy
2. Server information
*
server name:
server location:
internal IP address:
internal DNS FQDN:
request external FQDN:
Server OS
*
Windows
UNIX/Linus
MAC
Other:
Is this a:
*
first time server registration
registered server w/more services being added?
If you are changing a server address, please enter the old address:
3. Services needed
Please explain the Intended use for each of the services in the info box below.
Service Name
Port(s)
1
2
3
4
5
4. Please explain what the server is being used for and who the intended audience is:
*
(You can enter as much information as you wish.)
Other comments: