DIMACS COMPUTING FACILITIES Application for Computer Account 1. Last Name: _________________________________________________ 2. First Name: _________________________________________________ 3. Last 4 digits of your Social Security Number: ______________________ 4. Permanent E-mail Address (Required): ___________________________ 5. Are you a : Post Doc Fellow Rutgers Graduate Student Long Term Short Term Visitor REU Student DIMACS Permanent Member DIMACS Temporary Employee 6. Your Arrival Date: ______________________________________ Your Departure Date: ____________________________________ 7. Do you currently or have you had in the past a UNIX Account within Rutgers University? Yes No If yes, Username: _____________________________________ Machine Host: __________________________________ 8. Do you want to be added to the DIMACS Announcement mailing lists: Yes No Staff use only: Login:__________ Group: ____________ Date:________ Rm:______