Application for Internet Electronic Mail Account

Please type or print clearly the following information:

Last Name: ______

First Name: ______

Position Title: ______

Library/Institution Name: ______

Department Name: ______

Library/Institution Address: ______

City: ______

Zip Code: ______

Office Phone#: ______

Does your Library have a default email disclaimer? Yes____ No____

Do you require a Roaming Profile? Yes_____ No_____

By checking here – this means that you agree to the Terms of Service for the Roaming Profile SLA: Yes_____ No_____

Please check the appropriate distribution lists that this staff member needs to be part of. Please check all that apply:

____Administration ____Customer Service/ Circulation ___Financial ___Outreach

____Programming–Adult ____Programming–Children ____Programming-Older Adult

____Programming – Teen ___Reference ____Technical Services ____Youth Services All

_____Youth Services County

Supervisor's Name Printed: ______

Supervisor's Signature: ______PLEASE FILL OUT BOTH SIDES OF APPLICATION

You must read the eiNetwork Terms of Service and sign the "conditions" statement on the lower portion of this form, before we can establish your account.

eiNetwork

CONDITIONS OF INTERNET ELECTRONIC MAIL ACCOUNT USE

All electronic mail account holders through the eiNetwork system are required to sign the following use agreement.

1. I will not knowingly allow others to use my electronic mail account. 2. Access to the Internet via my account is for the purpose of the objectives listed in the eiNetwork Electronic Mail Policy. All use of my account must be consistent with these objectives. Use of my account for other activities could result in its termination. 3. Any attempt to interrupt or in any way degrade the operation of eiNetwork computer systems will result in immediate termination of my account and may also be subject to legal action. 4. eiNetwork reserves the right to access all information stored in its computer system for the purpose of ensuring compliance with the conditions stated in the eiNetwork Terms of Services, and applicable State laws. 5. I have read and I understand the eiNetwork Electronic Mail Policy, and I accept the conditions it contains.

Name: ______

Library/Institution Name: ______

Signature: ______

Date: ______

Please Fax Application to: eiNetwork Support Center 412-375-0301

** If you have technical questions, problems or have forgotten your password, please contact the eiNetwork Support Center at 412-622-3146. The default email box limit is currently 200MB.