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Get Internet Protocol (ip) Address Service Request - Prairie View A&m ...

Ust be signed before request will be honored. Send completed form to Information Technology Services SR Collins Room 126. Call 936-261-9300 for request inquiries. Please allow 3 business days for processing. Contact Information Location Requested By: Phone Number: E-mail Address: Office Location: Bldg: Dept: Approver Information Location Name: Phone Number: E-mail Address: Dept Head: (Mandatory) Office Location: Bldg: Dept: Dept Head : (Mandatory Signature Date: Please Print Date: Pl.

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