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Application Form For Wi-Fi Connection

The document is an application form for availing Wi-Fi internet connectivity on the North Maharashtra University campus. It requests permission from the Director of the School of Computer Sciences. The applicant must provide personal details like name, designation, employee code/PRN number, department, user type and contact number. For students, the academic year must be specified. Device details like company name, model number, serial number, MAC address and assigned IP address are also required. The applicant declares that the internet will only be used for research/education and they will be liable for any misuse under the IT Act 2000. Space is provided for recommendation of the head/director and approval of the director of the School of Computer

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595 views1 page

Application Form For Wi-Fi Connection

The document is an application form for availing Wi-Fi internet connectivity on the North Maharashtra University campus. It requests permission from the Director of the School of Computer Sciences. The applicant must provide personal details like name, designation, employee code/PRN number, department, user type and contact number. For students, the academic year must be specified. Device details like company name, model number, serial number, MAC address and assigned IP address are also required. The applicant declares that the internet will only be used for research/education and they will be liable for any misuse under the IT Act 2000. Space is provided for recommendation of the head/director and approval of the director of the School of Computer

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|| अंतरी पेटवू ज्ञानज्योत ||

उत्तर महाराष्ट्र ववद्यापीठ


पत्रपेटी क्र.८०,उमववनगर, जळगाव

Application form for Availing Wi-Fi Internet Connectivity on NMU Campus

To,
Prof. Dr. B. V. Pawar,
Director School of Computer Sciences,
North Maharashtra University Jalgaon.
Sir, I hereby request you to kindly, grant me permission to use Wi-Fi internet facility on the
university campus. For the same reason, I am enclosing necessary details as follows:
Personal Details
Name :-
Designation / Class :-
Employee Code / PRN NO: -
Department / School :-
User Type:- (Staff / Student):- Contact No:-
Academic Year (For student) from: 20 up to: 20 (Account will be deleted on 1st Jun of up to year)
Date of Retirement (for staff): (Account will be deleted on Date of Retirement)
Device Details:
(1) Company Name:- (2) Company Name:-
Model No:- Model No:-
Serial No:- Serial No:-
Mac Address:- Mac Address:-
Assigned IP Address:- Assigned IP Address:-
(Will be provided by computer network center) (Will be provided by computer network center)

Declaration
I hereby declare that, I will use the requested Wi-Fi internet facility only for research / educational
purposes. I will be liable, as per IT Act 2000 and its Amendments, for any misuse and/or neglect of this
Internet facility from my registered devices.

Date:- -------------- Signature of Applicant

-------------------------------------------------------For Office Use Only------------------------------------------------------

Recommendation of Head/Director:

(Head / Director of concern School /Department)

Director
School of Computer Sciences

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