MCW Libraries

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Proxy Server Access Request Form

Faculty, staff, students and residents 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)
 
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Page Updated 06/16/2014