Remote WIFI Device Form

Fields marked with an asterisk (*) are required.

• Name *

  First Last
• Phone *

  - Area Code - Prefix Line Number
• IU Email * Must be IU Email Address, no personal email addresses.
• Confirm Email Address *

  Must be IU Email Address, no personal email addresses.

• Anticipated graduation term: *
  Fall Spring Summer
• Anticipated graduation year: *
• Current Zip code: *
• Do you have an updated device that supports wifi? *
• Rationale for the remote WiFi: *