Information Systems and Technology Clubs and Organizations Authorization Form

Name of Club/Organization:
President’s (or similar officer) Name (First & Last): / University Advisor’s Name (First & Last):
CSUN Email: / CSUN ID#: / Advisor’s CSUN Email:
Phone #: / Advisor’s Phone #:
The use of computers for communication and networking has been extended to university recognized student clubs and organizations. Technology extended to university recognized clubs and organizations includes:
·  Access to an electronic mail (email) account;
·  Opportunity to develop a “homepage” linked to the university homepage; and
·  Assistance in accessing this technology from the Matador Involvement Center (MIC)
The use of this technology by student clubs/organizations must be consistent with the mission of the club/organization as stated in its constitution and bylaws on file in the MIC. Personal, business or any other non-authorized use of a club/organization’s email, homepage or other technology is a violation of this privilege and may result in disciplinary action taken against the student club/organization. Such action could result in the suspension of access to these particular services or in the revoking of the group’s recognition status.
Having thoroughly read the above statement as well as all campus policies that govern IT located at http://www.csun.edu/policy/, I hereby seek official use of the club/organization account. I affirm by my signature below that members (and initiates) will be educated as to the content of this document and the aforementioned policies. I also realize, and have educated my club/organization to the fact that any violation of the campus policies could result in my club/organization’s loss of this privilege as well as having an effect on the status of our university recognition.
President’s (or similar officer) Signature: / Date:
University Advisor’s Signature: / Date:
Primary User (Sponsor): / Additional User (Sponsor):
Full Name (First & Last): / Full Name (First & Last):
CSUN Username: / CSUN Username:
CSUN Email Address: / CSUN Email Address:
Phone Number: / Phone Number:
Existing/Requested Email Alias:* / Existing/Requested Website Account Username/ID:**
*The email you want for your club (example: yourclub@my.csun.edu) / **The website you want for your club (example: www.csun.edu/~yourclub)
Official Use Only
Received By: / Date:
Date Ticket Submitted To IT: / By Whom:
Received By IT & Sent To Requestor: / Date:
Approved Website Account Username/ID:
Approved Email Alias:

Revised 7/13/2016 White Copy: MIC Pink Copy: Requestor