<p> Application for Internet Electronic Mail Account</p><p>Please type or print clearly the following information:</p><p>Last Name: ______</p><p>First Name: ______</p><p>Position Title: ______</p><p>Library/Institution Name: ______</p><p>Department Name: ______</p><p>Library/Institution Address: ______</p><p>City: ______</p><p>Zip Code: ______</p><p>Office Phone#: ______</p><p>Does your Library have a default email disclaimer? Yes____ No____</p><p>Do you require a Roaming Profile? Yes_____ No_____</p><p>By checking here – this means that you agree to the Terms of Service for the Roaming Profile SLA: Yes_____ No_____ </p><p>Please check the appropriate distribution lists that this staff member needs to be part of. Please check all that apply:</p><p>____Administration ____Customer Service/ Circulation ___Financial ___Outreach </p><p>____Programming–Adult ____Programming–Children ____Programming-Older Adult </p><p>____Programming – Teen ___Reference ____Technical Services ____Youth Services All </p><p>_____Youth Services County</p><p>Supervisor's Name Printed: ______</p><p>Supervisor's Signature: ______PLEASE FILL OUT BOTH SIDES OF APPLICATION</p><p>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.</p><p> eiNetwork</p><p>CONDITIONS OF INTERNET ELECTRONIC MAIL ACCOUNT USE</p><p>All electronic mail account holders through the eiNetwork system are required to sign the following use agreement.</p><p>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.</p><p>Name: ______</p><p>Library/Institution Name: ______</p><p>Signature: ______</p><p>Date: ______</p><p>Please Fax Application to: eiNetwork Support Center 412-375-0301</p><p>** 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. </p>