Hosting Application - WDS@Columbia University

Columbia University Biomedical and Health Information Services (CUBHIS)

Web Site Hosting Services - Web Site Hosting/Vanity URL Request

This request form is intended for people who have/will have a Web site and:
1) Want to contract with the Web Design Studio (WDS) for site hosting space and support.
2) Need a new or additional domain name (Web address) for your web site.

Please Note: CUMC has strict guidelines for Web site addressing. Please review these guidelines and seek appropriate approval before submitting your request.

View Hosting guidelines. | View Vanity URL guidelines

Instructions

To request hosting services, please fill out the form below. Upon submission of the form, you will receive a confirmation page with instructions on how to complete the request. Trouble with this form? Please call tech support at 5-Help.

Account Holder Information

New Account

Account Renewal

Requestor's Name:

E-mail Address:

Telephone Number:

Dept., Lab, or Program Name:

Request Type

Site Hosting Only
Current URL:
Current Hosting Provider:
(A WDS representative will contact you to discuss details and timing for site migration.)

Domain Name (URL) Request & Hosting
Domain Name Desired:	*
Second Choice:	*
Description: This information will be used to evaluate your request. Please provide ALL necessary additional information about your domain name request that will be useful in the General Council's Office decision-making process.
If this is an existing Name, please indicate your Current Registrar:
and the Current Registrar's website:

Web Site Information

Do you already have a site?

Yes No

If No, can we contact you about our site design service?

Yes No

If Yes, specify current URL:

Will the new URL point to the same site?

Yes No

If No, please specify where this URL should point:

Do you host your site with WDS?

Yes No

(If No, a WDS representative will contact you to discuss your site migration to our server.)

Billing Information

Departmental Administrator's Name:
Departmental Chair's Name:
Account # for billing purposes: (x-xxxxx or x-xxxxx-xxxx) (Your department administrator will furnish you with this number.)
Contact Name (for billing questions):

User Agreement

With the submission of this document you confirm that you are in fact the requester of the above mentioned site, and that your department is aware of your hosting request. You also agree to follow any Web site rules and standards as set by the Columbia University Medical Center Web Steering Committee, and Columbia University Network Security and Privacy Policies.

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