Electronic Account Application

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Longview Independent School District
Technical Services
Electronic Accounts Application for Employees

Applicant Information
Please Note: As of May 15, 1999, all information on this application must be completed before an account will be issued. All information should be given exactly as it is recorded in the official records of Longview Independent School District. If an employee is not in the personnel records of the district, he may not be able to receive an account.

Applicant's first name: ____________________________________

Applicant's middle name: __________________________________

Applicant's last name: ____________________________________

Applicant's social security number OR employee ID number: ____________________

Campus: ______________________________________________

Account Information Please check the type of account you wish to have. Check all that apply.
___ Electronic Mail

___ Unix (persons needing EDP access only)

___ Windows NT

___ Dial-in Access

Please indicate your expected uses for your account(s).
_______________________________________________________________________

_______________________________________________________________________

Acceptable Use Policy
All user accounts at Longview Independent School District are governed by the current Longview Independent School District Technology Policies and Longview Independent School District's Acceptable Use Policy(AUP). It is recommended that you read all policies and agreements before signing this form. By signing this application, you are agreeing to abide by these policies.

Applicant's Signature All information on this application is true. I agree to abide by the policies dictated by Longview Independent School District. I understand that these policies may change at any time. I am aware that my electronic account privileges may be revoked for any reason at any time.

Signature _____________________________________________ Date ________________

...........................................................................................................................................................................................................................
Office Use Only:
Request is: Granted _______ Denied_______ Reason: _____________________________

Assigned user name: ____________________ Assigned Server(s): ___________________

Date of Activation: _____________________ Authorized by: _______

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