Please fill out this entire form to request a Professional Page account.  Thank you.

Required fields are marked by an *

1. Please fill out your contact information:  Please note: Your last
    name will be your User Name.

Last Name:* 

First Name:* 

E-mail:* 

Tel:* 

2. *For which department is this page being created?  Choose
      from one of the following two menus.*

  BiologyBusinessFACULTY -- Choose from hereChemistryEngineering/Engineering TechnologiesEnglish/Fine Arts/ Mondern LanguagesHealth TechnologiesEconomics/Government/HistoryLibraryMathematicsPractical NursingPsychology/Sociology

  STAFF -- Choose from hereInformation TechnologiesPayrollPhysical PlantAssessment, Planning, & ResearchHuman ResourcesPurchasing

3. *What HTML editor will you be using?*

  Microsoft FrontPage
  Netscape Composer
  TeamFusion
  Other 

4. Who is the intended audience for your Web page?  (optional)

  Students
  Faculty
  Staff
  Potential Students
  Researchers
  General Public
  Other 

5. Briefly describe what your web site will contain.  (optional)

6. *Have you followed the UCC´s Web Page Publishing
      Guidelines?   Yes       No 

7. *Will you use one of the UCC´s official TeamFusion
       templates?   Yes        No 

8. How often do you anticipate updating some portion of your
     page(s)?  (optional)

Please choose time periodWeeklyMonthlyOnce each semesterAnnuallyOther 

Print a copy of this form and get it signed from your department head

Department Head ______________________________

Date _______________