Home » Undergraduate Students » Forms

Group Account Request Form

Printer-friendly version

Brock University
Department of Computer Science
Group Account Request Form

Course: __________________________________________
Group Number: ______________ (if assigned by prof.)
Group Leader: __________________________________________
Student Number: ______________ (group leader)
Contact Address: __________________________________________
  __________________________________________
  __________________________________________
Phone Number: ____________________
E-Mail address: __________________________________________
SID LOGIN Signature
_____________ _____________ ___________________________________________
_____________ _____________ ___________________________________________
_____________ _____________ ___________________________________________
_____________ _____________ ___________________________________________
_____________ _____________ ___________________________________________
_____________ _____________ ___________________________________________
_____________ _____________ ___________________________________________

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.