Affiliate Form

Please provide the following information in order to be set up or renew access to BU secure wi-fi, a BU ID, and/or a BU Kerberos account.

Are you setting up a new Affiliate account or looking to renew your Affilliate status?*
- New Affiliate
- Renewal
Affiliates are defined as individuals who are not compensated by the university, but that require physical or electronic access to university resources(such as our Shared Labs).
Name*
First Last
Contact Phone Number*
Please provide your date of birth*
MM slash DD slash YYYY
Non-BU Email Address*
If you already have a BU email address, please provide your BU email address.
If you already have a BU ID, please enter below starting with U.
Please provide your company name (N/A if not applicable)*
Please provide your Photonics Center office room number (N/A if not applicable)*