PsyIT Department of NYSPI- ONLINE REQUEST

DHCP Registration Request Form:

Please note this: Your request will be logged into the PsyIT Help Desk system and you will receive a case number. You need your case number in order to check on the status of your request.

If you need to request an IP address for a SERVER or PRINTER, fill out the Patch/Static IP Request Form.

Items with * are required.

Requested by: (If requested by a third person)
Requestor's email address: GroupWise/Columbia email address.
First Name: *
Last Name: *
Title: *
Email Address:* GroupWise/Columbia email address
Department: * If Other, please specify:
Computer Support Person:*
Building: *
Floor:*
Room Number:*
Work Phone:*	xxx-xxx-xxxx
Type of Computer:*
Operating System:*
Hardware Address: *	00:00:00:00:00:00 MAC - Media Access Control Also known as the Hardware address 12 Hexadecimal Characters: 0-9, A-F only Click here for more information
Supervisor's Full Name: *
Supervisor's Email: *