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U N I V E R S I T Y
Member of Association of Indian Universities & Approved by UGC (Govt. of India) under 2(f) & 12(B)

wi-fi Internet Connection form

G1
Registration form for Wi-Fi access:

Registration No.:-_____________________________________________ Date:-_____________________________________

Name: _______ ___________________________________________Father's Name:_____________________________________________
Designation (only for employer):_________________________________ Faculty __________________________________________
Year/Semester (only for students):-_____________________Department:____________________________________________
Hostel _________________________________________________________________________________________________________________
Day Scholar/Hostler:-______________________ Hostel No. (If Hostler):______________Room No.:-______________________
Mobile No:-_____________________________E-mail Id:-__________________________________________@poornima.edu.in
Desktop /Laptop/Mobile:-________________________Physical Address (Mac):-_______________________________________

You are NOT supposed to:

· Extend or modify the network in any way. This includes adding any personally owned wireless access
points.
· Use this service for any activity which violates local, state, or federal law. Any attempt to break into or
gain unauthorized access to any computer or systems from a wireless connection is prohibited.
· Posting or dissemination material which is unlawful or material which violates copyright or intellectual
property rights.
· Use of peer-to-peer networks to download and/or upload material which violates copyright or
intellectual property rights.
· Using the service in an attempt to gain unauthorized access to another computer, electronic
communications systems, or telecommunications system regardless of the intention or outcome.
· Run high bandwidth consuming applications and operations such as downloading large music files and
video from the internet.
· Running any unauthorized data packet collection program on the wireless network. Such practices are a
violation of privacy and constitute the theft of user data.

Declaration by User:

I hereby undertake to abide by all the above terms and conditions for availing the facility of wireless
access at campus, the violation of which gives liberty to management to take appropriate action against me.
I also agree to follow the rules notified by the management time to time.

Signature of Applicant

For Office Use (not to be filled by applicant)

User Name issued:-_______________________________________Password:-_______________________________________________
Machine ID:-_______________________________________________Voucher No.:-____________________________________________

Signature of Network Administrator