RU-EDM Request Form
Email address *
Department Name *
Example "Office of Information Technology"
A Short 3-5 letter acronym for your ORG. Example "OIT"
Primary Contact *
Name of the Primary Contact of the requested ORG.
Primary NetID *
NetID of Primary Contact, used for account creation.
Primary Email Address *
Email Address of Primary Contact
Primary Phone Number *
Phone number of Primary Contact
Secondary Contact
Name of the backup contact for the requested ORG.
Secondary Email Address
Email Address of Secondary Conact
Secondary Phone Number
Phone Number of Secondary Contact
Estimated Client Count *
Approximate the number of Client Machines you will have in the requested ORG.
Networks in requested ORG. *
Provide all Network IP Ranges that will be included in this ORG. Format ""
Remaining Support Team Members
Please list the Name and NetID of all IT staff members.
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