IP/DNS Resource Request Form

This form should be used to request the change of an IP/DNS Resource. If you wish to add an IP/DNS resource, click here. If you wish to remove an IP/DNS resource, click here

Existing Device Information

Existing IP address of
device (if applicable): . . .

Existing DNS Name of device (if applicable)

Hardware (MAC) Address - - - - -

This device is a:

Server

Workstation

Printer

Other

New Device Information

New IP address of
device: . . .

What DNS Name is being requested for this device?

Hardware (MAC) Address - - - - -

What Subnet/VLAN would you like this device placed in?

Administrator Information:

Existing Server/Device Administrator

Server/Device Administrator name:

Phone number:

E-Mail Address:

Location:

Fax number:

New Server/Device Administrator

Server/Device Administrator name:

Phone number:

E-Mail Address:

Location:

Fax number:

Comments

Authentication Information

Your CSUN User ID