Website Request Form

Please complete and print the following form for each website you wish to create. The completed form, along with the appropriate advisor signature must then be sent to User Support Services, who will forward the request to the system administrators for approval.

Please complete all fields below:

WEBSITE INFORMATION
URL:

Is this a:

New Site
  Change to an Exisiting Site

 
POINT OF CONTACT INFORMATION
Name:
Organization Name:
Phone Number:
E-mail Address: @longwood.edu

ADVISOR APPROVAL
By signing, you authorize creation of the above named website on Longwood's server. You verify that the website will be used in accordance with Longwood's Acceptable Use Policy and that any abuse of the folder will be immediately reported to IITS.


 
Name (printed): E-mail Address: @longwood.edu
Signature: ____________________________________ Date:

For IITS Use Only!

 
Sys. Admin. Signature: __________________________________ Date: ____________________