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Proxy Access Request

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Proxy Server Access Request Form

Faculty, staff, students and residents will now use their MCWCORP/MCW email username and password
to log onto the proxy server.

Volunteer clinical faculty, adjunct faculty and emeritus faculty should submit this form even if they have MCW email addresses.

You will be able to review the form before submitting.

MCW Libraries will verify your status with the Office of Faculty Affairs and the appropriate department, and contact you within five to seven business days with your proxy login information.

Questions? Contact MCW Library Systems at 414-955-4290 or syst@mcw.edu between 8 am and 5 pm, or Circulation at 414-955-8300 on evenings and weekends.

* = Required Field

*
First Name	MI

*
Last Name

*	*
Email Address	Phone Number (w/Area Code)

*
Company/Clinic/Institution

Please provide a home or business address, whichever is the best one to reach you:
*
Street address

*	*	*
City	State	Zip

If the zip code above is a business, please provide your home zip code:

Status:*

Adjunct Faculty

Emeritus Faculty

Volunteer Clinical Faculty

Children's Hospital employee

Froedtert/Dynacare employee

Joint Graduate Degree program

Department affiliation:*
Notes: (Please provide any additional information you feel is necessary to clarify your status)

MCW Libraries

Faculty, staff, students and residents will now use their MCWCORP/MCW email username and password to log onto the proxy server.

Faculty, staff, students and residents will now use their MCWCORP/MCW email username and password
to log onto the proxy server.