1.	Last Name:____________________ First Name:___________________ M.I.:____
	Spell name as would appear on University documents, such as course schedule.


	Student ID Number:________________________________________________________


	UML Student Email Address:________________________________________________________


2. Please check off your Computer Science course enrollment status.  


   If you are not a Computer Science major, but are taking a Computer Science
   class whose course # begins with 91, please check off the 'Non-CS major'
   box and write in the course number.

	CS Doctorate 		
	CS Graduate	
	CS Undergraduate       Expected year of completion: ________
	Non-CS major taking CS course -------> Course Number: 91._______
	
3. Account Renewal
	If you had a temporary UNIX account in the past year, check below and enter 
	your username.  You must fill out section 2 above.

	Renewal                     Previous username: 

Submitting:
	Sections 1 and 2 MUST be complete and clear, or your account may not be 
	properly created. 

	Bring this form, your student ID card and a copy of 
	your schedule to Olsen 312 for processing.

	By signing this form you agree to comply with University and Computer 
	Science policies found at http://www.cs.uml.edu/policy.

		Signature: ___________________________________	Date: ______________