Brock University
Department of Computer Science
Group Account Request Form
| Course: | __________________________________________ |
| Group Number: | ______________ (if assigned) |
| Group Leader: | __________________________________________ |
| Student Number: | ______________ (group leader) |
| Brock Email: | __________________________________________ |
| Alternate Email: | __________________________________________ |
| Student Num | Username | Signature |
| _____________ | _____________ | ___________________________________________ |
| _____________ | _____________ | ___________________________________________ |
| _____________ | _____________ | ___________________________________________ |
| _____________ | _____________ | ___________________________________________ |
| _____________ | _____________ | ___________________________________________ |
| _____________ | _____________ | ___________________________________________ |
| _____________ | _____________ | ___________________________________________ |
| Additional Resource Requests: | ___________________________________________ | |
| Date of Application: | _________________________ |
| Signature of Applicant: | ____________________________________ |
| Instructor's Signature: | ____________________________________ |
In signing this form I acknowledge that I have read and that I understand the Computer Science Department Policies (available on the department's Web Server: http://www.cosc.brocku.ca/ ), and I understand that failure to comply with these Policies will result in the loss of my user privileges.