Please fill out all fields in this form completely and accurately.
(Examples of modems are below)

First Name: Last Name:
Room Number: (please list corresponding room letter, if applicable)
Room Phone : 825- Additional Phone:
E-mail :
MAC Address: (this is located on the back or bottom of your modem)
 

 

 

 

 

 

 


Locate your HFC MAC ID on the back or bottom of your modem. Some modems may say Ethernet Address.
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