Unsecured Wi-Fi Usage Exception Request Form
Request approval to use an unsecured Wi-Fi network. Complete all fields to submit your exception request. This form is not intended for sensitive or health-related information.
Full Name
*
First Name
Last Name
Work Email Address
*
example@example.com
Department or Team
*
Please Select
Engineering
Product
Sales
Marketing
Customer Support
Other
Device Type
*
Please Select
Laptop
Tablet
Smartphone
Other
Device Operating System
*
Please Select
Windows
macOS
Linux
iOS
Android
Other
Location of Unsecured Wi-Fi Network
*
Date(s) of Intended Use
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Estimated Duration of Use (in hours)
*
Reason for Exception Request
*
Supervisor or Manager Name
*
Submit Request
Should be Empty: