1. LAKENet Special Access Agreement
  2. 2011-2012 School Year
      1. District Signatures:



LAKENet Special Access Agreement

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2011-2012 School Year

By signing this document, it is understood and agreed that the requesting school district is fully aware of the ramifications of open access and the possible security breaches that may occur by opening the district network to the internet. Further, the district assumes full responsibility for this address and use within LAKENet and on the Internet. There is no cost for the first 3 IP addresses per district. Special access after the first three IP addresses is $587.15 per school year per IP address (subject to change with notice). The district LAKENet coordinator will be notified by email when access is established. In order to ensure that the request is in keeping with the mission of LAKENet, all fields below must be completed before processing will occur. If additional space required please attach list. Please allow 5 working days from receipt of fully completed form for processing.  The form must be signed by the district superintendent and district LAKENet coordinator. Special access is only available for servers and each device/ip number requires a separate registration form.
Requesting District __________________________________________________________________________________________
Building ___________________________________________________________________________________________________
Date Requested _____________________________________________________________________________________________
IP Number:
Full name of host with domain (only required if DNS is needed):
Location of host:
Tag or Serial Number:
Protocol (please circle type):    TCP      UDP      Both
Access from (please circle type):  Internal Only    External Only    Both
Port Number or Numbers:
Educational Purpose for Access:

District Signatures:
Superintendent: ___________________________________________________________________________Date:_____________
District Technology Coordinator: ____________________________________________________________ Date:____________

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Newark, NY 14513-1863      
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