LDAP Members Area Userid Request Form
By submitting this CalConnect Userid Request Form, I confirm that:
I am an employee, officer, or authorized volunteer of a CalConnect member organization.
I am requesting this userid with the approval of my organization's primary representative.
Granting this userid will establish me as a CalConnect Member Representative.
My organization has agreed to the
CalConnect Membership Agreement
I will comply with that agreement and with the
CalConnect Code of Conduct
ISO 3166 Country Code
CAPTCHA. Here's where we determine that you’re a real human being and not an automated process. Please type the text shown below into the box to the right
Fields labeled in
are required. The combination of first and last name, and the userid fields must be unique in the database. If they have already been used, you will be instructed to press the "back" button on your browser to return to this page to enter new values until unique values for both "firstname lastname" and "userid" have been entered.
E-mail is required so we can return the information about your new ID to you.
Organization is the name of the Member organization of the consortium which you represent.