RCI Guest Account Request Application Form
Level of Difficulty: Beginner
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This form must not be used for new employees, or errors in RIAS III will occur.
Please print clearly. Submit the completed form to Accounts Office, New Brunswick Computing Services, Hill Center, 110 Frelinghuysen Road, Busch Campus. Fax: 732-445-4263
Accounts are for the current academic year. Sponsors must re-approve each guest every year. We will e-mail renewal instructions to each guest RCI account when the account needs to be renewed.
Part I: (To be completed by the guest)
First Name: _________________ Middle Initial: _____ Last Name: _______________________
SS#: _______________ Birthdate(MM/DD/YY): ______________ Gender: F ______ M ______
Daytime Phone: ___________ Home Phone: ____________ Alternate E-mail: ___________________
I need this account/NetID until _____________. (No period of more than 12 months at a time will be permitted).
agree to use this account in accordance with the
Acceptable Use Policy
Guidelines for Computing and Information Technology Resources (http://oit.rutgers.edu/acceptable-use.html).
Signature: _______________________________________ Date: ______________________
Part II: (To be completed by the sponsor)
First Name: ___________________________ Last Name: _____________________________
Department: _____________________________ Job Title: ____________________________
Campus Address: _____________________________________________________________
Please direct questions about this form to the NBCS Help Desk at (732) 445-HELP (4357).