Firewall Port opening request form

Office of Information Technology
Lincoln University
822 Chestnut Street Schweich Hall   Jefferson City   Missouri  65102-0029   (573)681-5888   Fax: (573)681-5368

Residence Hall Student requests for gaming port openings through the LU Firewall
Date: 5-16-05
The service is available from 7:00 P.M. to 7:00 A.M. Monday through Friday and Saturday and Sunday all day. 
Requests forms are to be submitted to the Student Life Office for approval. The request will then be sent to OIT for security verification and setup. The Firewall modification will be made to the Firewall during the next scheduled maintenance window. Maintenance windows during the beginning of the semester are scheduled monthly. 
Name: __________________________________
Dorm Room: _____________________________
Phone Number: ___________________________
E-mail address: ___________________________
Service (game or other program name): _____________________________
Company: ____________________________________________________
Platform (PC, Xbox, PS2, etc.):____________________________________
TCP port(s): ___________________
UDP port(s): ___________________
Student Life Signature: __________________________________ Date: ___________
OIT Network Services Signature: __________________________ Date: ___________