Step 1: Customer Information

Faculty
Staff
Student
Retiree
Other__________
(Circle Student)


• Login ID - List your UK log in ID from your email address before the uky.edu in the address.
• Last Name, First Name, Middle Initial – List Student name as indicated.
• Social Security Number – List number as indicated.
• Department/Organization – List student organization name.
• Phone Number – Phone number where you can be reached.
• Today’s Date – Date form is completed

Step 2: Service Requested

New Account
Password Reset
Update Information
Delete Account

(Circle One)

• Justification – student organization web site.
• Signature of Account Owner - sign the form

Step 3: Account Information

• Select Which Systems Apply to Your Request:

(Circle WWW)

Step 4: Faculty & Staff Must Have the Following Completed:

• Leave Blank
• Turn in completed form to the SOC Administrative offices to be processed.