I have read the Plattsburgh State University Information Provider Agreement. I agree to abide by the rules and provisions therein.
Name:_____________________________________________________________ Department Chair or Club Advisor Name:____________________________ Local Address:____________________________________________________ Telephone (Local):________________________________________________ Telephone (Home):_________________________________________________ Faculty/Student Username:_________________________________________ Title Of Homepage:________________________________________________ Requested URL: http://clubs.plattsburgh.edu/______________________ Brief Description of Information to be Posted:____________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________
______________________________________________ _____________ Information Provider's Signature Date ______________________________________________ _____________ Departmental Approval or Co-Signator Date
Print and send this form to Symen Mulders or Shawn Aguglia, Computing & Media Services, Feinberg Library.