Request To Open Websites For Student Use
    I hereby request that following website(s) be unblocked for the dates and times specified.
    Website(s)
    Start
    Date
    End
    Date
    Course Name *
    * If this site is to be opened just for one class of students, please provide a list of those
    students and their year of graduation as listed on your class lists.
    The reason for this request is:
    ________________________________________________________________________
    ________________________________________________________________________
    ________________________________________________________________________
    ________________________________________________________________________
    ________________________________________________________________________
    ________________________________________________________________________
    ________________________________________________________________________
    I understand that by asking for this unblocking I am taking the responsibility that I will
    monitor my students carefully while using these sites.
    Signature
    Date of Request
    Name (Please Print)

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