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Voice: 202-687-4949, Fax: 202-687-1162 Email: netidservices@georgetown.edu, http://www.georgetown.edu/uis NetID Password Reset and Increase in Level of AssuranceYou may use this form if you have forgotten your NetID, NetID password, or if you need to have your level of assurance raised. Print this form, complete the information and fax it to 202-687-1162. A confirmation email message will be sent to the address specified below. 1. My NetID: ______________________ Graduation Year: ______ 2. Last Name:_______________________ First Name:_____________________ MI: ___ 3. Daytime Phone Number: ______ - ______- ________ 4. Email Address: _____________________________________________________ 5. Check as many as apply: 6. The service to which I am primarily seeking access is: 7. Identification:
Signature: ________________________________ Date: __________________ Note: DO NOT include your Social Security Numbers on this form! |