IP Address Request Form

The IP request form can be used to:

request a new IP address
transfer an IP to another device
update DNS information.

A new IP address is required when a device is moved to a new subnet (vlan). Generally this is the case when moving to a new building. In such cases the old IP address may be kept by the department for other use or returned where it will be recycled back into the general inventory.

NOTE: Please allow up to 2 business days for request to be completed.

All questions marked with a are required.

Requester Contact Information

First name:
Last name:
Email:
Phone:
Department:

Request Type Is this request for a new IP or to transfer an IP to another device?

Request type
If request is to Transfer IP, enter the IP address to transfer:

Primary User Contact Information

First name:
Last name:
Email:

Device Information

If your computer does not have a Computer/Host name and you are unsure what it should be, leave field blank and one will be created for you.
A computer name or hostname is the label (name) assigned to a device (host) on a network and is used to distinguish one device from the other devices on that network. Computer/Host name:
How to find Computer/Host name & MAC/Physical Address. Apple-Mac Users | Windows Users
MAC/Physical Address:
Type of device
If type of device selected is "Other", enter device type:

Select the building where the device will be located:

Building:

Other Information Additional instructions or information:

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IP Request Form