Print the following form out and send it to Fox Web/IIT Department.

UW-Fox Valley Web Account Request Form
Due By: End of September Academic Year: ______

Return this form to:

Fox Web/IIT Department
UW-Fox Valley
1478 Midway Road
Menasha, WI 54952
920.832.2884 * foxweb@uwc.edu

Date of submission: __________________
___ New account  ___ Renewal account 
 ___ Requesting to use the campus logo
Name of Individual/organization: ____________________________________________
Title of Web page: _______________________________________________________
Fox Web will use the title as the name of the link on the Web.
URL address: __________________________________________________________
If this is an existing page, provide the current URL address. If this is an initial application, Fox Web will provide the URL address.
Head of department/unit: _________________________
Email address: ________________ Phone: _______________
Person responsible for design and upkeep of this Web page: ________________________
Email address: ________________ Phone: _______________
I have read "UW-Fox Valley Web Policy" and agree to manage this Web page in accordance with the requirements of this document.

______________________________
(Department Head's Signature)

_____________________
(Date)

______________________________
(Designer's Signature)

_____________________
(Date)

(For Office use only)

Date of approval: ____________ Logo usage approval: __________
Page URL: _________________________________________
Special notes:  
       

Signature or initials of Fox Web: _________________________________