Database Request

This form is for Rose-Hulman students, staff, or faculty to request a database for web-based applications. Additional information about this service can be found at http://www.rose-hulman.edu/TSC/services/web_pages/databases/.

Complete this form, being sure to answer each question as thoroughly as possible. When you are finished, click the button that says "Submit".

Name:

Position:

Freshman
Sophomore
Junior
Senior
Graduate Student

Staff
Faculty
Alumni
Other

Email:

Campus Mail Box:

Phone Number:

Preferred Contact Method:

Database Use:
(Club or Course requires
Faculty/Staff authorization)

Database Software:

Database Name:
(Only used for Club or Course databases)

Database Username:
This cannot be your kerberos username

Database Password:
This cannot be your kerberos password

Comments or Additional
Information: