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DHCP Registration Request Form:

Please note this: Your request will be logged into the PsyIT Help Desk system and you will receive a case number. You need your case number in order to check on the status of your request.

If you need to request an IP address for a SERVER or PRINTER, fill out the Patch/Static IP Request Form.

Items with * are required.

Requested by: (If requested by a third person)
Requestor's email address:
GroupWise/Columbia email address.
First Name: *
Last Name: *
Title: *
Email Address:*
GroupWise/Columbia email address
Department: *
If Other, please specify:
Computer Support Person:*
Building: *  
Room Number:*
Work Phone:* xxx-xxx-xxxx
Type of Computer:*
Operating System:*
Hardware Address: *

MAC - Media Access Control
Also known as the Hardware address
12 Hexadecimal Characters: 0-9, A-F only

Click here for more information


Supervisor's Full Name: *
Supervisor's Email: *




Firewall Exception list request
email request
patch request
novell login request
vpn request
network folder request
DNS request
Purchase requisition