Alumni netID Account Request

Please submit this form to request a netID account. The form will be submitted to Alumni and Parent Relations for processing. Items in bold are required.

Please note: submitting this form is the initial step in the process to provide an alumnus with a netID account. The other steps in this process may take up to seven business days and require the alumnus to visit the office of Alumni & Parent Relations:

to show an official photo identification card,
to sign this form agreeing to acceptable use expectations,
to update contact information, and
to pick up username, password and e-mail account information.

These steps are necessary due to the broad extent of services that your netID account provides.

Name:


First		MI		Last

Graduation Date:

	/
mm		yyyy

Date of Birth:


Month	Day	Year

SXU Person (Student) ID:

Phone Number:

( ) -

Address:

Street


City		State		Zip