Request an IP Address

Fill out the form below to request an IP Address.

Full Name:
Phone Number:
Enter the Officer/Workspace Number:
Location should be in the form of either "2139" for an office number or 2.A.19 for an "open workspace".
Jack Number:
Please enter the entire text that is on the label on the jack that you intend to plug this host into, in the form: "TC - 2nd Floor East 23A".
Please enter the division you are working for, in the form of "MCS" or "ALCF" or "CLS", etc.
Please enter your desired hostname for this request.
Hardware MAC Address (Wired ONLY):
Please enter a valid wired MAC Address.
Operating System:
Please choose the Operating System you are using.
CSI Number:
If this device has a CSI number, please provide it.
Old CSI Number:
If this is replacing an old host, please provide the CSI number of the old device.
Needed Until:
If you know when this machine is no longer needed, give us a date that we can deactivate it.
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