Active Directory Request Form

Service Requested:

Machine Name:

Operating System:

Is this a Laptop?:

Location of Computer:
Room: Building:

Owner's Name:

Owner's Department:

Owner's Telephone Number:

Owner's UBitname (if new group is needed):

Group Permissions:

Group Member UBitnames or Other Instructions:

University at Buffalo - State University of New York

Science & Engineering Node Services (SENS)