First Name: * Middle:   * Last:    *

**Your Official Name that is listed on your Social Security Card.  

Department
  Academic Affairs Academic Support Center Accounting & Financial Reporting Administration & Finance Admissions Alumni Relations Aramark Dining Services Athletics Biological and Environmental Sciences Bookstore Budget Campus Recreation Career Center Cashiering Center for Economic Education Chemistry and Physics Department College of Arts and Sciences College of Business & Economics - Dean College of Education and Human Services Communication Studies Commuter Student Affairs & Student Leadership Programs Conferences, Facility Scheduling, & Non-Credit Education Continuing Education Center - Halifax-South Boston Office Cormier Honors College Counseling Center Crater Small Business Development Center of Longwood University Dean of Students Disability Resources Education, Special Education, Social Work, & Communication Disorders English, Philosophy & Modern Languages Environmental Health and Safety Facilities Management Financial Aid G.I.V.E. Office Golf Course Graduate Studies Greek Affairs Health, Recreation & Kinesiology History & Political Science Honor/Judicial Programs Housekeeping Human Resources Infant Toddler Connection Information Technology Services Institutional Advancement Internal Auditor International Affairs L.C.C.L.L. Library & Library Sciences Longwood University Campus Police Longwood University Center for the Visual Arts Longwood University Foundation Longwood University Institute for Teaching Through Technology and Innovative Practices Longwood University Printing Services Longwood University Small Business Development Center - Danville Office Longwood University Small Business Development Center - Farmville Office Longwood University Small Business Development Center - Martinsville Office Longwood University Small Business Development Center - South Boston Office Materiel Management Mathematics & Computer Science Military Science Multicultural Affairs Music New Student Programs Nursing Nursery School Payroll Post Office President's Office Psychology Public Relations Real Property Management Registration Office Residential and Communter Life Residence Education Coordinators School of Business & Economics Sociology & Anthropology Southside Area Health Education Center Southside Virginia Business & Education Commission Sports Information Student Accounts Student Affairs Student Health Teacher Education Student Union Theatre, Art, & Graphic Design Virginia Comprehensive Health Education Training and Resource Center Virginia Writing Office Wellness Center *

Please indicate your status by choosing one of the following:

Faculty  Staff  Other (Non-Employee) 

Please indicate your status by choosing one of the following:

Part-time  Temp Please Select One Full-time  Other (Non - Employee) *

Budget Code:

Title *

Office Location: 509 Pine Street Arc Athletics Complex Barlow Bedford Blackwell Bristow Center for Communication Studies and Theatre Chicester Science Building Clark Cox Coyner Craft House Crater SBDC of Longwood University Curry Dorrill Dining Hall East Ruffner Frazer French Golf Course Graham Grainger Hardy House Health and Fitness Center Heating Plant Hiner Hull Iler Jarman Lancaster Lancer Park Lankford Library Longwood Landings Longwood Village LSBDC/Danville LSBDC/Martinsville LSBDC/South Boston Main Cunningham McCorkle North Cunningham North Tabb Off Campus Off Campus (Visitor) Psych. Lab South Cunningham South Tabb Stevens Stubbs Tabb Third and Main Streets Center for the Visual Arts West Ruffner Wheeler Willett Wygal Wynne *

Room #:

If you are replacing someone, please indicate here who you are replacing:

Please enter your start date at Longwood:

Please fill in your new telephone number and check the circles that apply to you.

Phone Number *

Change name display
Change voice mail pass code
Request a LancerNet Account (includes network and e-mail accounts)

Is the computer you are using in an office that was previously networked?

Yes  No, I will need a new network connection installed 

In order for us to provide you with the best customer service possible, please take the time to fill out the following information (employee only).

My computer is a: MAC  PC 

I am currently running the following operating system (OS): MAC OS Windows2000 Professional WindowsXP Windows Vista

I will need access to shared calendaring for my department:

I will need access to the following shared printer(s):

Dept. Contact

*

Contact Phone

*

Contact E-mail

(complete e-mail address)*

Prior to Processing User Support Services will confirm all above information.