New Physical Hosting Request Form

If you would like a consultation or assistance completing the following fields, please click here

If your request is for more than one device, add that information in the "Comments" section below. You do not need to fill out a request form for multiple systems.

Required fields are marked with an asterisk (*)

Personal Information


Departmental Information

Project Name:
FOAPAL (for billing):

Hosting
Who will be managing this device:
Desired Location:

 Enroll in the Data Center Backup service
More information about Data Center backups (including costs)


Server Information

Manufacturer:
Model:
Type:
Size (In Rack Units):
Typical watts of power the device will consume when in normal operation:
Preferred Hostname:
Purpose:

IS-3 Security Designation:


More information about security controls
IS-12 Availability Requirement:
Who will install this device:

Network Configuration

 Install behind the Data Center firewall

If your equipment will be installed behind the Data Center firewall, we will work with you to ensure that you are aware of the default firewall rules, and (if needed) assist in requesting new firewall rules.

 A networked management port is required (for example, for iDRAC, ILOM or IPMI)

Network speed:
Number of jacks:
Network segment(s):

Contact Information

Technical Contact:
Technical Contact Email:

A representative from the Data Center will work with you throughout the process to successfully bring your equipment online. You will be notified of the cost/rate if applicable for this service prior to final approval.

Comments: