Department Name________________________Date________________

Please choose a first and second choice username for your departmental account. The email address will be the username@armstrong.edu. You will be notified when your account is ready by phone or email.
 

1. __________________________________________

2.________________________________________________________________

I verify that the above information is correct. The undersigned applicant hereby requests a user account to gain access to Armstrong Atlantic State University Academic Computer Systems. Your signature certifies that you are aware of and will comply with the conditions of issuance of this user account as set forth in Computer and Information Services Policy 92-001 and all local, state, and federal laws regarding computer use. The Georgia Computer Systems Protection Act is incorporated herein by reference. If you would like copies of these policies or laws, please contact CIS. I understand that this account is subject to termination without notice should I violate this agreement in any way.
 
 

Person Responsible for Account ____________________________________
 

Phone Number of the Above Individual ________________________________
 
 

Department Head or Director Signature _______________________________
 

Note: This is a departmental account. It is up to the Department head to decide and manage who has access to this account. More than one person can log in and use this account.
 

Picked up by: Date: