FORM: Applying for a Blue Plate

Applying for a Blue Plate

NOTE: Requests will only be accepted from a UniSA staff member.

For systems that need to connect to the University network (i.e. require an IP) that did not come from a designated supplier you will need to apply for a Blue Plate. Once your application has been approved you will be notified, your Blue Plate sticker will be mailed to you and an IP will be issued based on your nominated campus. Once you receive it, you will need to place the Blue Plate sticker on your hardware in a prominent place.

Requestors Username:

Best Contact Number:

ORG2 Code:

Campus:

Building:

Level:

Room:

Suggested DNS name:

System Type:

Manufacturer make:

Manufacturer model:

NIC Manufacturer:

MAC address:

What will the machine be used for?

Additional Notes:

Terms and Conditions

I understand and acknowledge that it's my responsibility to ensure the information I have provided above is accurate and have already discussed this change with involved parties.

I acknowledge that I have already completed and received approval for previously submitted Hardware Supplier Exemption Form.

Yes

Further Assistance

If you require further information or assistance, please contact the IT Help Desk on (08) 830 25000 or 1300 558 654.