Multiple Non-Student Remote Access Request Complete this form to request Becker Library remote access accounts for multiple non-student, WUSM personnel (faculty, staff, residents, fellows, post docs, etc.) at the same time. The department contact will receive an email confirmation while login details will be sent directly to the account holders. Logins cannot be provided in advance of the account holders' beginning work at Washington University School of Medicine. The cost of an individual proxy account for faculty and staff is $25 per fiscal year. There is no proration for accounts requested partially through the year and no refunds are given for accounts cancelled during a fiscal year. Account requests using this form must be charged to a Washington University departmental account. Contact Becker Library Information Services at 314-362-7080 or email@example.com if you have questions or need assistance logging in to your account.Department Contact InformationPlease enter contact information in case we have any questions about the user list you supply.Name* First Last Email Address* Department*Billing InformationFIS Billing (Dept.) Number*Billing Contact Name* First Last Billing Contact Email Address* Account Holder InformationSelect your method of supplying the new user list. You may either upload a list or supply a list in the form itself. Please include the following for each new user: Full Name Status (Resident, Fellow, Faculty, Staff, PostDoc, etc.) WU Email Address if known (any email address is useful) Start Date if requesting in advance How will you supply the list?*Email a list to the LibraryAdd the list to a text fieldPlease email your list of users to firstname.lastname@example.org.Questions or CommentsCommentsThis field is for validation purposes and should be left unchanged.