Network Patching Request Form Network Patching Request Form Contact Name: * Contact Phone #: * Contact Email: * Site Contact: * Complete Jack ID Info: * Necessary VLAN Needed: What equipment is being used on the jack? * Computer (PC or Mac) Phone Printer Camera (DSS only) Building Automation Sensor or other device Other network enabled device Please specify the type of equipment being connected to the new jack location. If Other, please specify: Location Building Name: * Building Floor: Building Room #: Is special access required? * Yes No If this site or area requires special access which ITS technicians may not have access to, please select Yes. If special access is required, please provide contact name and number: More Information For more information on Jack Activations, see the following: Jack Activation KB Article This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
