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  • Gaming Device Registration Request Form

Please fill out the following information to process your request.

NOTE: To obtain the IP and MAC addresses requested below, please make sure your gaming device is powered on and connected to the wired ethernet port on the wall.

(*) indicates a required field


Requestor Contact Information
* First Name :
* Last Name :
* Email Address :
* Phone Number:
Residence Hall Information
* Building :
* Floor Number :
* Room Number :
Gaming Device Information  -- please see note above
* Gaming Device :
* IP Address :
* MAC Address :  
Comments :
You will be notified by email or phone when the request has been processed.