UCSB Chemical Engineering Wireless/UCSB NetID Request Form
Use this form to request a UCSB NetID which allows access to the UCSB Wireless.
First Name *
Your answer
Middle Name
Your answer
Last Name *
Your answer
Email Address *
Your answer
Birth Date *
Your answer
Date you will leave UCSB? *
Your answer
Faculty Member Sponsoring Your Visit
Submit
Never submit passwords through Google Forms.
This form was created inside of University of California, Santa Barbara. Report Abuse - Terms of Service - Additional Terms