Network Request Form

Use this form to request fixed hostnames/ip addresses, network jack activations, and network jack reconfiguration within CSE.
Contact and Owner Information


Device information

Device Manager/User

Check the box below if the device's primary manager or user is different from the requester listed above.
What do you need?
Check all that applies:
New hostname/IP address...
  • You do not need to request a hostname if you just need a dynamic/dhcp network connection.  Fill out this section only if you specifically need to access your device remotely via a static hostname/address.
  • The hostname you receive will be in the "" name space.
  • Before submitting this request, please check to be sure the name you are requesting does not already exist.  Use the "host" or "nslookup" commands, or any of the many online hostname lookup sites.
Network port info
What kind of address/subnet will you be using on this port?
Other info
If the previous form fields do not cover your situation or you need to give additional explanation, please describe here: