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Wifi Form

The document appears to be an application form for Wi-Fi connectivity access at Madurai Kamaraj University for either staff or students using laptops. It requests general information about the applicant as well as technical details of their device. Applicants must agree to the university's terms and conditions and the form requires various approvals before an account is set up.

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suriyanarayanan707
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154 views3 pages

Wifi Form

The document appears to be an application form for Wi-Fi connectivity access at Madurai Kamaraj University for either staff or students using laptops. It requests general information about the applicant as well as technical details of their device. Applicants must agree to the university's terms and conditions and the form requires various approvals before an account is set up.

Uploaded by

suriyanarayanan707
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Madurai Kamaraj University

(University with Potential for Excellence)

WI-FI CONNECTIVITY ACCESS APPLICATION FORM FOR - STAFF (LAPTOP ONLY)

1.General Information
Name of the Staff
Employee ID No Gender: Male/ Female
Category Teaching/ Non- Teaching
Designation
Name of the School
Department/Centre/Section
Contact Details Intercom No: Mobile No:
Landline No:
E- mail ID

2.Technical Information
Details of Device Laptop : Make & Model
Serial No
Mac/Physical Address
Operating System Windows/Unix/Mac/Linux/Others(Specify)

I hereby declare that the above information given by me is true and correct. I accept all the terms
and conditions laid down by MKU and hereby take-up the responsibility for any violation that would be
caused by my username.

Date: Signature of the Staff

DR/AR HOD/ Chairperson/Director


With seal with seal

*************************************************************************************
* Enclose Xerox Copy of the Staff ID-Card.

For Office Use Only:


User Name : Password :

IP assigned: DHCP/ Specific IP Expiry: Never / Specific Date


Verified by Network Administrator
Signature With Date
Approved by Coordinator/Deputy Coordinator -TSC
Signature with Date
Status of Account with Date Opened On: Closed On:
Madurai Kamaraj University
(University with Potential for Excellence)

WI-FI CONNECTIVITY ACCESS APPLICATION FORM FOR - STUDENT (LAPTOP ONLY)

1.General Information
Name of the Student / Scholar Roll No:
Name of the course / Programme Gender: Male/ Female
Department/Schools Name
Name of the Faculty / Guide
( Research scholars only )
Course Duration From: To:
Residential Hostel / Days Scholar
Contact Details Room No ,Hostel Name :( if applicable)
Mobile No:
E-Mail Id:

2.Technical Information
Type of Device Laptop : Make & Model
Serial No
Mac/Physical Address
Operating System (OS) Windows/Unix/Mac/Linux/Others(Specify)

I hereby declare that the above information given by me is true and correct. I accept all the
terms and conditions laid down by MKU and hereby take-up the responsibility for any violation that
would be caused by my username.

Date: Signature of the Student

Hostel Warden (if applicable) HOD Chairperson


with seal with seal with seal
******************************************************************************
*Enclose Xerox copy of the Student ID-Card

For Office Use Only:


User Name: Password:
IP assigned: DHCP/ Specific IP Expiry: Never / Specific Date
Verified by Network Administrator
Signature With Date
Approved by Coordinator/Deputy Coordinator -TSC
Signature with Date
Status of Account with Date Opened On: Closed On:

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